According to a recent article published in the journal Cancer, elevated levels of beta-2 microglobulin may indicate a worse prognosis for patients with early-stage Hodgkin’s lymphoma, suggesting these patients may derive long-term benefit from more aggressive therapy.
Hodgkin’s lymphoma is a cancer of the lymph system, which is part of the immune (infection fighting) system that includes blood vessels, bone marrow, lymph nodes and lymph vessels that are present throughout the body. It also includes organs such as the spleen, thymus and tonsils. This cancer is characterized by the presence of the uncontrollable growth and division of atypical white blood cells (immune cells) that crowd lymph tissue, suppressing the formation and function of other cells normally found in this tissue. Hodgkin’s disease usually begins in a single lymph node and is capable of spreading throughout the body. Early-stage Hodgkin’s lymphoma refers to cancer that is small and has not spread to distant sites, but is contained within one region of the body. Standard treatment for early-stage Hodgkin’s typically consists of radiation therapy plus chemotherapy.
Although early-stage Hodgkin’s lymphoma is considered to be a very curable disease, a small percentage of patients experience a recurrence of their cancer and may ultimately die from their disease. Therefore, researchers continue to explore patient or cancer variables that may help indicate the prognosis of a patient so that treatment may become more individualized. A protein that is found on some cells and in the blood, called beta 2-microglobulin, is used as a prognostic indicator for some hematologic (blood) cancers such as multiple myeloma or non-Hodgkin’s lymphoma (NHL).
Researchers from MD Anderson Cancer Center recently analyzed data, including beta 2-microglobuling levels, from 217 patients diagnosed and treated with early-stage Hodgkin’s lymphoma between 1987 and 1995. Most patients were treated with chemotherapy followed by radiation therapy. All patients achieved a complete disappearance of detectable cancer (complete remission). However, 28 patients experienced a cancer recurrence and 19 patients died. Five years following treatment, cancer-free survival was 88% and overall survival was 95%. The only predictor of overall survival was beta 2-microglobulin levels in the blood, with high levels indicating a worse overall survival. Predictors of worse cancer-free survival included male gender, bulky disease (cancer measuring over 10 centimeters in diameter) and a trend toward higher beta 2-microglobulin levels.
These researchers concluded that the level of beta 2-microglobulin in the blood of patients with early-stage Hodgkin’s lymphoma may provide a valuable predictor of how a patient will respond to therapy, enabling physicians to provide more individualized treatment regimens for these patients. In addition, this test is easily performed, inexpensive and widely available. The authors state that larger clinical trials further evaluating beta 2-microglobulin as a prognostic indicator are warranted in patients with early-stage Hodgkin’s lymphoma. Patients diagnosed with early-stage Hodgkin’s lymphoma may wish to speak with their physician about the risks and benefits of receiving this test or the participation in a clinical trial evaluating other prognostic variables. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (cancer.gov) and www.eCancerTrials.com eCancerTrials.com also provides personalized clinical trial searches on behalf of patients.
Reference: Chronowski GM, Wilder RB, Tucker S. An elevated serum beta-2-microglobulin level is an adverse prognostic factor for overall survival in patients with early-stage Hodgkin disease.