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Beta-2-microglobulin is an independent predictor of progression in asymptomatic multiple myeloma†
Article first published online: 2 MAR 2010
Copyright © 2010 American Cancer Society
Volume 116, Issue 9, pages 2188–2200, 1 May 2010
How to Cite
Rossi, D., Fangazio, M., De Paoli, L., Puma, A., Riccomagno, P., Pinto, V., Zigrossi, P., Ramponi, A., Monga, G. and Gaidano, G. (2010), Beta-2-microglobulin is an independent predictor of progression in asymptomatic multiple myeloma. Cancer, 116: 2188–2200. doi: 10.1002/cncr.24959
The first author designed the study, interpreted data, performed statistical analysis, and drafted the article; the last author supervised the study design and data interpretation and drafted the article; the second author contributed to data collection and statistical analysis; the third, fourth, fifth, sixth, and seventh authors collected and revised clinical data; and the eighth and ninth authors collected and revised pathologic data. All authors read and approved the article.
- Issue published online: 20 APR 2010
- Article first published online: 2 MAR 2010
- Manuscript Accepted: 17 AUG 2009
- Manuscript Revised: 14 JUL 2009
- Manuscript Received: 26 MAY 2009
- Progetto Integrato Oncologia 2006, Ministero della Salute, Rome, Italy
- Ricerca Sanitaria Finalizzata, Regione Piemonte, Torino, Italy
- Progetto Alfieri, Fondazione CRT, Torino, Italy
- Novara-AIL Onlus, Novara, Italy
- multiple myeloma;
- beta-2 microglobulin;
Although serum beta-2 microglobulin (B2M) represents a key variable for symptomatic multiple myeloma (MM) prognostication, its role in predicting the risk of progression of asymptomatic MM to symptomatic disease has not been explored.
This study was bases on a consecutive series of 148 patients with asymptomatic MM and explored the cumulative probability of progression to symptomatic MM as the primary endpoint.
In univariate analysis, a serum B2M level >2.5 mg/L was associated with an increased probability of disease progression (5-year risk, 64.5%; P < .001) along with serum monoclonal component (sMC) (P < .001), urinary monoclonal component (uMC) (P < .001), and bone marrow plasma cells (BMPCs) (P < .001). In multivariate analysis, serum B2M was selected as an independent predictor of progression (hazard ratio, 3.30; P = .002). Serum B2M was combined with sMC, uMC, and BMPC to create a risk-stratification model based on 4 groups with different risk of progression: very low (5-year risk, 0%), low-intermediate (5-year risk, 19.6%), high-intermediate (5-year risk, 60.7%), and high (5-year risk, 80.7%). The model that included serum B2M along with sMC, uMC, and BMPC was able to predict disease progression better than the model that was based on sMC, uMC, and BMPC without serum B2M (C statistics, 0.760 vs 0.726).
The current results indicated that 1) serum B2M is an independent predictor of asymptomatic MM progression, and 2) serum B2M adds prognostic information when combined with the most widely used prognosticators of asymptomatic MM progression. Cancer 2010. © 2010 American Cancer Society.