Beta‐2‐microglobulin is an independent predictor of progression in asymptomatic multiple myeloma

Abstract

BACKGROUND: Although serum beta-2 microglobulin (B2M) represents a key variable for symptomatic multiple myeloma (MM) prognostication, its role in predicting the risk of progression of asymptomatic MM to symptomatic disease has not been explored. METHODS: This study was bases on a consecutive series of 148 patients with asymptomatic MM and explored the cumulative probability of progression to symptomatic MM as the primary endpoint. RESULTS: In univariate analysis, a serum B2M level >2.5 mg/L was associated with an increased probability of disease progression (5-year risk, 64.5%; P < .001) along with serum monoclonal component (sMC) (P < .001), urinary monoclonal component (uMC) (P < .001), and bone marrow plasma cells (BMPCs) (P < .001). In multivariate analysis, serum B2M was selected as an independent predictor of progression (hazard ratio, 3.30; P ¼.002). Serum B2M was combined with sMC, uMC, and BMPC to create a risk-stratification model based on 4 groups with different risk of progression: very low (5-year risk, 0%), low-intermediate (5-year risk, 19.6%), high-intermediate (5-year risk, 60.7%), and high (5-year risk, 80.7%). The model that included serum B2M along with sMC, uMC, and BMPC was able to predict disease progression better than the model that was based on sMC, uMC, and BMPC without serum B2M (C statistics, 0.760 vs 0.726). CONCLUSIONS: The current results indicated that 1) serum B2M is an independent predictor of asymptomatic MM progression, and 2) serum B2M adds prognostic information when combined with the most widely used prognosticators of asymptomatic MM progression.

Novel Filtration Markers as Predictors of All-Cause and Cardiovascular Mortality in US Adults

“…The growing literature about BTP and B2M suggests they provide promising avenues for developing a larger range of options for clinical testing in the future, although algorithms for combining filtration markers require further work, which may benefit from studies where measured GFR is available. Additionally, while assays for BTP and B2M are relatively low cost and available on automated analyzers and B2M is used in clinical practice (as a prognostic factor in multiple myeloma 52,53 ), BTP is currently a research test and would require approval for clinical use. The current literature is most developed for cystatin C where clinical applications, including confirmation of CKD in patients with eGFR cr 45–59 mL/min/1.73m 2 without albuminuria or other markers of kidney damage.…”

Tumour Markers and Kidney Function: A Systematic Review

“…The normal serum b2m concentration range is 1.5–3 mg/L, typically every day 2.4 mg/kg is produced [39]. Higher serum levels suggest an increased production that can occur in (1) lymphoproliferative diseases, such as multiple myeloma, beta-cell chronic lymphocytic leukemia, Hodgkin's disease, and non-Hodgkin's lymphoma, (2) inflammatory conditions, such as systemic lupus erythematous, rheumatoid arthritis, Sjogren's syndrome, and Crohn's disease, (3) some viral infections, such as cytomegalovirus, non-A and non-B hepatitis, and mononucleosis [40]. Concerning its use in oncology b2m levels correlate with the disease stage and poorer prognosis in patients with multiple myeloma or chronic lymphocytic leukaemia and it is the most important predictor of treatment-free survival and overall survival of patients affected by lymphocytic leukaemia and generally in most of lymphatic neoplasia [41, 42].…”

Rediscovering Beta-2 Microglobulin As a Biomarker across the Spectrum of Kidney Diseases

“…β 2 M predicts not only the prognosis but also the progression of asymptomatic disease (HR 3.30; P  = 0.002) (280) and even outcomes after stem cell transplantation (281, 282). The association between serum β 2 M and albumin upon patient prognosis in myeloma, not only is reminiscent of similar associations noted in the dialysis literature but also is very robust statistically.…”