Prognostic value of serum beta2-microglobulin in patients with Waldenstrom's macroglobulinemia requiring treatment.
OBJECTIVE
Waldenstrom's macroglobulinemia (WM) is a lymphoplasmacytoid lymphoma characterized by a relatively indolent course with median survival ranging from 5 years to 10 years in different series. Several clinical and laboratory variables have been associated with inferior survival, such as advanced age, hyperviscosity, presence of cytopenia, and hypoalbuminemia. Recent data indicate that serum 2-microglobulin (2M) might also be significant. The purpose of our study was to assess possible correlations of 2M with clinical and laboratory variables and to further evaluate its association with cause-specific and overall survival (OS) of patients with WM requiring treatment.


METHODS
We analyzed 124 patients with WM with an available pretreatment value of 2M. Median age was 70 years (range, 28-89 years), and median survival was 105 months. Multiple clinical and laboratory parameters were evaluated for their possible correlation with OS.


RESULTS
Patients with older age, anemia, thrombocytopenia, hypoalbuminemia, and higher creatinine levels had significantly greater serum 2M levels. This variable was associated with impaired cause-specific survival and OS in the whole group of patients and in patients aged </= 70 years. More specifically, OS for all patients according to serum 2M > 4 mg/dL versus </= 4 mg/dL was 79 months versus 115 months (P = 0.01).


CONCLUSIONS
Our data provide further evidence that high 2M levels are an important parameter associated with inferior OS and cause-specific survival of patients with WM requiring treatment. This parameter may be used to stratify patients involved in prospective clinical trials.
Anagnostopoulos
Athanasios
A
Department of Clinical Therapeutics, University of Athens School of Medicine, Athens, Greece.
Zervas
Konstantinos
K
Kyrtsonis
Marie
M
Symeonidis
Argyris
A
Gika
Dimitra
D
Bourantas
Konstantinos
K
Zomas
Athanasios
A
Anagnostopoulos
Nikolaos
N
Pangalis
Gerasimos
G
Dimopoulos
Meletios Athanasios
MA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia; D005260:Female; D006801:Humans; D008206:Lymphatic Diseases / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D008258:Waldenstrom Macroglobulinemia / Q000097:blood* / Q000175:diagnosis* / Q000628:therapy; D001613:beta 2-Microglobulin / Q000097:blood*
D001613:beta 2-Microglobulin