Beta-2-microglobulin is an independent predictor of progression in asymptomatic multiple myeloma

Authors

  • Davide Rossi MD,

    Corresponding author
    1. Division of Hematology, Department of Clinical and Experimental Medicine, Amedeo Avogadro University of Eastern Piedmont and Maggiore della Carita Hospital, Novara, Italy
    • Division of Hematology, Department of Clinical and Experimental Medicine, Amedeo Avogadro University of Eastern Piedmont, Via Solaroli 17, 28100 Novara, Italy
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    • Fax: (011) 39-0321-620421

  • Marco Fangazio MD,

    1. Division of Hematology, Department of Clinical and Experimental Medicine, Amedeo Avogadro University of Eastern Piedmont and Maggiore della Carita Hospital, Novara, Italy
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  • Lorenzo De Paoli MD,

    1. Division of Hematology, Department of Clinical and Experimental Medicine, Amedeo Avogadro University of Eastern Piedmont and Maggiore della Carita Hospital, Novara, Italy
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  • Alessia Puma MD,

    1. Division of Hematology, Department of Clinical and Experimental Medicine, Amedeo Avogadro University of Eastern Piedmont and Maggiore della Carita Hospital, Novara, Italy
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  • Paola Riccomagno MD,

    1. Division of Hematology, Department of Clinical and Experimental Medicine, Amedeo Avogadro University of Eastern Piedmont and Maggiore della Carita Hospital, Novara, Italy
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  • Valeria Pinto MD,

    1. Division of Hematology, Department of Clinical and Experimental Medicine, Amedeo Avogadro University of Eastern Piedmont and Maggiore della Carita Hospital, Novara, Italy
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  • Paola Zigrossi MD,

    1. Division of Hematology, Department of Clinical and Experimental Medicine, Amedeo Avogadro University of Eastern Piedmont and Maggiore della Carita Hospital, Novara, Italy
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  • Antonio Ramponi MD,

    1. Division of Pathology, Department of Medical Sciences, Amedeo Avogadro University of Eastern Piedmont and Maggiore della Carita Hospital, Novara, Italy
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  • Guido Monga MD,

    1. Division of Pathology, Department of Medical Sciences, Amedeo Avogadro University of Eastern Piedmont and Maggiore della Carita Hospital, Novara, Italy
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  • Gianluca Gaidano MD, PhD

    1. Division of Hematology, Department of Clinical and Experimental Medicine, Amedeo Avogadro University of Eastern Piedmont and Maggiore della Carita Hospital, Novara, Italy
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  • 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.

Abstract

BACKGROUND:

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.

METHODS:

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.

RESULTS:

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).

CONCLUSIONS:

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.

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