Beta-2 microglobulin is a strong prognostic factor in patients with DLBCL receiving R-CHOP therapy

Miyashita, Kazuho; Tomita, Naoto; Taguri, Masataka; Suzuki, Taisei; Ishiyama, Yasufumi; Ishii, Yoshimi; Nakajima, Yuki; Numata, Ayumi; Hattori, Yukako; Yamamoto, Wataru; Miyazaki, Tatsuya; Tachibana, Takayoshi; Takasaki, Hirotaka; Matsumoto, Kenji; Hashimoto, Chizuko; Takemura, Sachiya; Yamazaki, Etsuko; Fujimaki, Katsumichi; Sakai, Rika; Motomura, Shigeki; Ishigatsubo, Yoshiaki

doi:10.1016/j.leukres.2015.08.016

Cited by 30 publications

(26 citation statements)

References 24 publications

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“…β 2 ‐MG is synthesized in almost all nucleated cells and constitutes the light chain subunit of the human leukocyte antigen‐I (HLA‐I), which is distributed on cellular membrane . Investigators conducting studies in DLBCL speculated that higher serum β 2 ‐MG levels correlated with the absence of HLA‐I expression, which could lead to a defective recognition of tumor‐specific antigens by T cells. In accordance with previous studies, elevated β 2 ‐MG was proved to be associated with adverse clinical behaviors in DLBCL and included in the nomogram.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Nomogram for Overall Survival in Patients with Diffuse Large B-Cell Lymphoma

et al. 2019

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Purpose This study aimed to develop a prognostic nomogram in diffuse large B‐cell lymphoma (DLBCL) and compare it with traditional prognostic systems. Materials and methods We included 1,070 consecutive and nonselected patients with DLBCL in the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, between 2006 and 2012. A nomogram based on the Cox proportional hazards model was developed. Results The entire group were divided into the primary (n = 748) and validation (n = 322) cohorts. The 5‐year overall survival (OS) rate was 64.1% for the entire group. Based on a multivariate analysis of the primary cohort, seven independent prognostic factors including age, Ann Arbor stage, Eastern Cooperative Oncology Group performance status score, lactate dehydrogenase, β2‐microglobulin, CD5 expression, and Ki‐67 index were identified and entered the nomogram. The calibration curve showed the optimal agreement between nomogram prediction and actual observation. In addition, the concordance index (C‐index) of the nomogram for OS prediction was 0.77 (95% confidence interval [CI], 0.73–0.81) in the primary cohort and 0.76 (95% CI, 0.70–0.81) in the validation, superior to that of the international prognostic index (IPI), revised IPI (R‐IPI), and National Comprehensive Cancer Network (NCCN)‐IPI (range, 0.69–0.74, p<.0001). Moreover, in patients receiving rituximab plus CHOP (R‐CHOP) or R‐CHOP‐like regimens, compared with IPI (C‐index, 0.73; 95% CI, 0.69–0.77), R‐IPI (C‐index, 0.70; 95% CI, 0.66–0.74), or NCCN‐IPI (C‐index, 0.71; 95% CI, 0.66–0.75), the DLBCL‐specific nomogram showed a better discrimination capability (p < .0001). Conclusions The proposed nomogram provided an accurate estimate of survival of patients with DLBCL, especially for those receiving R‐CHOP or R‐CHOP‐like regimens, allowing clinicians to optimized treatment plan based on individualized risk prediction. Implications for Practice A diffuse large B‐cell lymphoma (DLBCL)‐specific prognostic nomogram was developed based on Chinese patients with DLBCL. As a tertiary hospital, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences is the number 1 ranked cancer center in China, with more than 800,000 outpatients in 2018. Patients included in this study were nonselected and came from 29 different provinces, municipalities, and autonomous regions in China. Thus, the data is believed to be representative to an extent.

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Section: Discussionmentioning

confidence: 99%

Prognostic Nomogram for Overall Survival in Patients with Diffuse Large B-Cell Lymphoma

et al. 2019

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“…The prognostic role of beta-2 microglobulin in patients with DLBCL treated with rituximab has not been fully investigated in previous studies except for the notable Japanese studies by Kanemsa et al and Miyashita et al [34, 35]. They reported that elevated serum beta-2 microglobulin was a poor prognostic predictor in patients with DLBCL in the rituximab era.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of serum beta-2 microglobulin in patients with diffuse large B-cell lymphoma in the rituximab era

et al. 2016

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The prognostic value of serum beta-2 microglobulin for diffuse large B-cell lymphoma (DLBCL) is not well known in the rituximab era. A retrospective registry data analysis of 833 patients with de novo DLBCL treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) was conducted to establish the prognostic significance of serum beta-2 microglobulin at a ≥2.5 mg/L cutoff. Five-year progression-free survival (PFS, 76.1% vs. 41.0%; p < 0.001) and overall survival (OS, 83.8% vs. 49.2%; p < 0.001) were significantly worse in patients with elevated serum beta-2 microglobulin (n = 290, 34.8%). Furthermore, the five parameters of the International Prognostic Index, accompanying B symptoms, bone marrow involvement and impaired renal function were associated with worse PFS and OS. In multivariate analysis, elevated beta-2 microglobulin was a significant poor prognostic factor for PFS (hazard ratio [HR], 1.70; 95% confidence interval [CI], 1.29–2.24; p < 0.001) and OS (HR, 2.0; 95% CI, 1.47–2.75; p < 0.001). In an independent validation cohort of 258 R-CHOP treated patients with de novo DLBCL, elevated beta-2 microglobulin levels remained a significant poor prognostic factor for PFS (HR, 2.03; 95% CI, 1.23–3.32; p = 0.005) and exhibited a strong trend of association with worse OS (HR, 1.64; 95% CI, 0.98–2.75; p = 0.062). The significance of serum beta-2 microglobulin levels as an independent prognostic factor for patients with DLBCL receiving R-CHOP is confirmed.

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“…Conclusion. When estimating sIL-2R, тк1, and β2-mG before treatment, the diagnostic and therapeutic processes can be monitored in the majority of patients with LPD.Keywords: soluble interleukin 2 receptor, thymidine kinase 1, lymphogranulomatosis. …”

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confidence: 99%

“…Серологиче-ские маркеры для мониторинга этой категории больных используются существенно реже из-за недостаточной чувствительности и специфичности тех из них, которые предложены для клинического исследования. В част-ности, это относится к β2-микроглобулину (β2-МГ) и лактатдегидрогеназе (ЛДГ) [1][2][3][4][5]. Следовательно, поиск новых маркеров для мониторинга больных с ЛПЗ остает-ся актуальным.…”

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“…В част-ности, увеличение сывороточного уровня sIL-2R служит диагностическим признаком гиперпролиферации лимфо-цитов при гемобластозах и является показателем неблаго-приятного прогноза течения опухолевого процесса [1,2,[14][15][16][17]. Кроме того, sIL-2R является неспецифическим маркером воспаления [14][15][16].…”

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Diagnostic value of soluble interleukin-2 receptor in patients with lymphoproliferative diseases

Parilova¹,

Sergeeva²,

Маршутина³

et al. 2016

Onkol. Z. im. P.A. Gercena

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1 московский научно-исследовательский онкологический институт им. П.А. Герцена -филиал ФГБу «национальный медицинский исследовательский радиологический центр» (ген. директор -акад. рАн А.Д. каприн) минздрава россии, москва, россия; 2 ФГБоу Во «российский национальный исследовательский медицинский университет им. н.и. Пирогова» (ректор -акад. рАн С.А. Лукьянов) минздрава россии, москва, россия Цель исследования -оценить клинико-диагностическую значимость растворимого рецептора интерлейкина-2 (sIL-2R) в сравнении с тимидинкиназой-1 (тк-1) и β2-микроглобулином (β2-мГ) у больных с лимфопролиферативными заболева-ниями (ЛПЗ) разных клинических групп. Материал и методы. Сывороточные уровни sIL-2R оценили с помощью наборов Bender medsystems (Австрия), тк-1 -«Biovica» (швеция) и β2-мГ -«Beckman Сoulter» (СшА) у 81 больного с ЛПЗ (I ста-дия -5 пациентов, II -23, III -25 и IV -28) до начала лечения. у 57 больных был установлен диагноз неходжкинской лимфомы (нХЛ) и у 24 -лимфогранулематоза (ЛГм). использовали рекомендованные дискриминационные уровни (Ду) маркеров: для sIL-2R -12,5 нг/мл, для тк-1 -50,0 ДЕд/л и для β2-мГ -800,0-2400,0 мкг/л. Результаты. Показано, что sIL-2R обладает умеренной диагностической чувствительностью у больных с ЛПЗ -53,2%. наиболее высокую диагно-стическую чувствительность показала тк-1 -86,4%; а для β2-мГ она оказалась наименьшей -40,0%. образованный ряд диагностической чувствительности маркеров тк-1>sIL-2R>β2-мГ оказался характерным для всех исследуемых групп больных с ЛПЗ. Средний уровень и доля случаев превышения Ду sIL-2R, наряду с тк-1 и β2-мГ, монотонно возрастали со стадией опухолевого процесса, подтверждая зависимость от стадии этих маркеров при ЛПЗ. не обнаружено достоверных различий по уровню и частоте случаев превышения Ду трех исследованных маркеров между группами ЛГм и нХЛ, а в группе нХЛ -между т-и В-клеточными, а также между индолентными и агрессивными лимфомами. По частоте превы-шения порогового значения для ЛПЗ на старте лечения сходную чувствительность, равную 87,7% (40,0% -при I стадии, 96,4% -при IV), имели пары β2-мГ+тк-1 и тк-1+sIL-2R. Положительным считали случай превышения Ду хотя бы одним маркером из пары. Сходные данные в парах были обусловлены высокой диагностической чувствительностью тк-1. Заклю-чение. При оценке sIL-2R, тк1 и β2-мГ до начала лечения мониторинг диагностического и лечебного процесса возможно будет проводить у большей части больных с ЛПЗ. Objective -to estimate the clinical and diagnostic value of soluble interleukin 2 receptor (sIL-2R) versus thymidine kinase 1 (Tk1) and β2-microglobulin (β2-mG) in patients with lymphoproliferative diseases (LPD) of different clinical groups. Subjects and methods. The serum levels of sIL-2R, Tk1, and β2-mG were measured using the kits of Bender medsystems (Austria), BIOVICA (sweden), and Сoulter Beckman (usA), respectively, in 81 patients with LPD (5 patients with stage I; 23 with stage II, 25 with stage III, and 28 with stage IV) before treatment. 57 and 24 patients were diagnosed with non-Hodgkin's lymphoma (nHL) and l...

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Beta-2 microglobulin is a strong prognostic factor in patients with DLBCL receiving R-CHOP therapy

Cited by 30 publications

References 24 publications

Prognostic Nomogram for Overall Survival in Patients with Diffuse Large B-Cell Lymphoma

Prognostic Nomogram for Overall Survival in Patients with Diffuse Large B-Cell Lymphoma

Prognostic significance of serum beta-2 microglobulin in patients with diffuse large B-cell lymphoma in the rituximab era

Diagnostic value of soluble interleukin-2 receptor in patients with lymphoproliferative diseases

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