The prognostic significance of beta(2)-microglobulin in patients with Hodgkin's lymphoma.
OBJECTIVE
Serum beta(2)-microglobulin (s beta(2)m) is an established prognostic factor for multiple myeloma and non-Hodgkin's lymphoma, but only limited data suggest an adverse prognostic significance for Hodgkin's lymphoma (HL). This study was undertaken to examine the impact of s beta(2)m on the prognosis of patients with HL.


METHODS
s beta(2)m was measured by a radioimmunoassay (upper normal limit 2.4 mg/L), in pretreatment serum samples of 232 patients with HL, who were then treated with ABVD or equivalent regimens with or without radiotherapy. Multivariate survival analysis was based on Cox's proportional hazards model.


RESULTS
Main patients' characteristics: median age 30.5 years (14-78); 58% males; 68% nodular sclerosis, 20% mixed cellularity and 12% lymphocyte predominance; 34% B-symptoms; 24% Ann Arbor stage I, 49% II, 18% III and 9% IV. Elevated s beta(2)m levels were detected in 65/232 patients (28%) and correlated with older age (p<0.001), mixed cellularity (p=0.03), B-symptoms (p=0.002), advanced stage (p=0.02), > or = 5 involved sites (p=0.02), inguinal/iliac involvement (p=0.009), lymphocytopenia (p=0.002) and elevated lactate dehydrogenase (p=0.01). The 7-year failure free survival (FFS) was 75% vs. 72% for patients with normal vs. elevated s beta(2)m (p=0.15). The corresponding 7-year overall survival (OS) rates were 86% vs. 52% (p=0.003). In multivariate analysis, elevated s beta(2)m was not predictive of FFS, but was independently associated with inferior OS (p=0.01), along with the number of involved sites (p<0.001).


CONCLUSIONS
s beta(2)m is not a potent prognostic factor for FFS in optimally treated patients with HL. However s beta(2)m may be predictive of OS, probably due to its effect on the timing of treatment failure.
Vassilakopoulos
Theodoros P
TP
Hematology Section, First Department of Internal Medicine, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.
Nadali
Gianpaolo
G
Angelopoulou
Maria K
MK
Siakantaris
Marina P
MP
Dimopoulou
Maria N
MN
Kontopidou
Flora N
FN
Karkantaris
Christos
C
Kokoris
Styliani I
SI
Kyrtsonis
Marie-Christine
MC
Tsaftaridis
Panayiotis
P
Pizzolo
Giovanni
G
Pangalis
Gerassimos A
GA
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002423:Cause of Death; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000097:blood* / Q000175:diagnosis / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011863:Radioimmunoassay; D016019:Survival Analysis; D001613:beta 2-Microglobulin / Q000097:blood*
D015415:Biomarkers; D001613:beta 2-Microglobulin