Serum beta 2 microglobulin and C‐reactive protein in the monitoring of lymphomas findings in a multicenter study and experience in selected patients

• Published in: Cancer 1980-01, Vol.45 (2), p.318-326
• Main Authors: Child, J. A., Spati, B., Illingworth, Sarah, Barnard, D., Corbett, Sheila, Simmons, A. V., Stone, J., Worthy, T. S., Cooper, E. H.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antineoplastic Agents - therapeutic use; beta 2-Microglobulin - analysis; Beta-Globulins - analysis; Blood Sedimentation; C-Reactive Protein - analysis; Female; Hodgkin Disease - blood; Hodgkin Disease - therapy; Humans; Lymphoma - blood; Lymphoma - therapy; Lymphoma, Large B-Cell, Diffuse - blood; Lymphoma, Non-Hodgkin - blood; Male; Middle Aged; Time Factors
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(19800115)45:2<318::AID-CNCR2820450220>3.0.CO;2-C

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, α1 acid glycoprotein (α1AGP), 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.