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The prognostic significance of beta(2)-microglobulin in patients with Hodgkin's lymphoma



The prognostic significance of beta(2)-microglobulin in patients with Hodgkin's lymphoma



Haematologica 87(7): 701-8; Discussion 708



Background and Objectives: Serum beta2-microglobulin (sbeta2m) 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 sbeta2m on the prognosis of patients with HL. Design and Methods: sbeta2m 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 sbeta2m 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), gtoreq5 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 sbeta2m (p=0.15). The corresponding 7-year overall survival (OS) rates were 86% vs. 52% (p=0.003). In multivariate analysis, elevated sbeta2m 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). Interpretation and Conclusions: sbeta2m is not a potent prognostic factor for FFS in optimally treated patients with HL. However sbeta2m may be predictive of OS, probably due to its effect on the timing of treatment failure.

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Accession: 011536492

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PMID: 12091120


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