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Serum beta 2 microglobulin and C‐reactive protein in the monitoring of lymphomas findings in a multicenter study and experience in selected patients
Author(s) -
Child J. A.,
Spati B.,
Illingworth Sarah,
Barnard D.,
Corbett Sheila,
Simmons A. V.,
Stone J.,
Worthy T. S.,
Cooper E. H.
Publication year - 1980
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19800115)45:2<318::aid-cncr2820450220>3.0.co;2-c
Subject(s) - beta 2 microglobulin , medicine , stage (stratigraphy) , erythrocyte sedimentation rate , gastroenterology , lymphoma , orosomucoid , glycoprotein , chemistry , biochemistry , paleontology , biology
Serum beta 2 microglobulin (β2m) and C‐Reactive protein (C‐RP) were measured in patients with Hodgkin's disease (HD) and non‐Hodgkin's lymphoma (NHL). In a vertical study of 215 patients with HD and 171 with NHL, the serum β2m was raised in 8% of stage I and II and 47% of stage III and IV active untreated HD; the corresponding frequencies for patients in “complete remission” (CR) off treatment were 4% and 18%. In active NHL, β2m was elevated in 23% of stage I and II disease and 60% of stage III and IV disease; the frequencies for CR were 10% and 21%. The serum C‐RP levels afforded interesting comparison: values >20 mg/l were found in 31% of stage I and II and 53% of stage III and IV active untreated HD. The corresponding frequencies for the CR groups were 5% in both. In active NHL, C‐RP was elevated in 23% of stage I and II and 40% of stage III and IV: the frequencies for the CR groups were 7% and 2%. When histopathological grade rather than clinical stage was considered in NHL, a raised β2m was found in association with “unfavorable” histologies in 78% of all untreated patients and 100% of stage IV disease. The detailed investigation of smaller numbers of patients including extended longitudinal studies provided additional information: the serum β2m was found to be independent of changes in serum C‐RP, α 1 acid glycoprotein (α 1 AGP), fibrinogen, and the erythrocyte sedimentation rate (ESR). It was elevated in advanced untreated disease and persistent elevation probably reflected resistant or partially responsive disease. Chemotherapy produced a reduction in serum β2m levels with each individual course of treatment; this change was either part of a continuing overall reduction to normal or was transient, producing a characteristic “zig‐zag” pattern. Biochemical tests in relation to fixed time points have limitations. Longitudinal studies can probably provide crucial information in only a small number of patients who are already being closely monitored. Nevertheless, serum β2m and C‐RP levels can furnish useful information of potential clinical value and prognostic significance.