From the Guidelines
Elevated Beta-2 (β2) microglobulin levels are a prognostic indicator of various conditions, including multiple myeloma, lymphoma, and leukemia.
Key Points
- In the context of multiple myeloma, a β2 microglobulin level greater than 3.5 mg/L is associated with a poorer prognosis, and levels above 5.5 mg/L are considered high-risk 1.
- Elevated β2 microglobulin levels may also be seen in patients with chronic kidney disease, particularly those on long-term hemodialysis, and in individuals taking immunosuppressive medications such as prednisone at doses exceeding 20 mg/day for prolonged periods.
- The level of β2 microglobulin reflects the tumor mass and is now considered a standard measure of the tumor burden 1.
- β2 microglobulin is used in the International Staging System (ISS) for multiple myeloma, which is based on easily obtained laboratory measures (serum β2 microglobulin and serum albumin) 1.
- The revised ISS (R-ISS) includes serum β2 microglobulin and serum albumin and prognostic information obtained from the LDH and high-risk chromosomal abnormalities detected by FISH 1.
Prognostic Value
- Elevated β2 microglobulin levels are associated with a poorer prognosis in multiple myeloma, with higher levels indicating a worse outcome 1.
- The prognostic value of β2 microglobulin is independent of other factors, such as serum albumin and LDH 1.
Clinical Implications
- Elevated β2 microglobulin levels should be considered in the diagnosis and management of multiple myeloma, as well as in the monitoring of disease progression and response to treatment 1.
- The use of β2 microglobulin as a prognostic indicator can help guide treatment decisions and improve patient outcomes 1.
From the Research
Elevated Beta-2 (β2) Microglobulin
Elevated Beta-2 (β2) microglobulin levels are associated with poor prognosis in several lymphoproliferative disorders, including:
- Multiple myeloma 2, 3, 4, 5
- Lymphoma 2
- Acute lymphocytic leukemia (ALL) 2
- Acute myeloid leukemia (AML) 6
Prognostic Factors
Elevated Beta-2 microglobulin levels are considered an independent prognostic factor for:
- Survival in multiple myeloma 3, 4
- Disease progression in asymptomatic multiple myeloma 5
- Response to chemotherapy and disease-free survival in AML 6
- Complete response rate and survival in ALL 2
Clinical Associations
High Beta-2 microglobulin levels are associated with:
- Older age 2
- Elevated creatinine, bilirubin, and alkaline phosphatase levels 2
- Low albumin levels 2
- B-cell disease 2
- Bence Jones myeloma 4
- Clinical stage III 4
- Anemia 4
- Renal failure 4
- Intense involvement of the general state 4
- Monocytic variants of AML (M4, M5) 6
- High white blood cell count 6
- High serum lysozyme levels 6
- Expression of monocytic membrane markers 6