Oncotarget

Research Papers:

Prognostic significance of serum beta-2 microglobulin in patients with diffuse large B-cell lymphoma in the rituximab era

Seyoung Seo, Jung Yong Hong, Shinkyo Yoon, Changhoon Yoo, Ji Hyun Park, Jung Bok Lee, Chan-sik Park, Jooryung Huh, Yoonse Lee, Kyung Won Kim, Jin-Sook Ryu, Seok Jin Kim, Won Seog Kim, Dok Hyun Yoon and Cheolwon Suh _

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Oncotarget. 2016; 7:76934-76943. https://doi.org/10.18632/oncotarget.12734

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Abstract

Seyoung Seo1,*, Jung Yong Hong1,*, Shinkyo Yoon1,7, Changhoon Yoo1, Ji Hyun Park1, Jung Bok Lee2, Chan-sik Park3, Jooryung Huh4, Yoonse Lee4, Kyung Won Kim5, Jin-Sook Ryu6, Seok Jin Kim8, Won Seog Kim8, Dok Hyun Yoon1, Cheolwon Suh1

1Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

2Department of Medical Statistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

3Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

4Department of Otorhinolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

5Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

6Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

7Department of Hemato-oncology, Bundang Jesaeng Hospital, Gyeonggi-do, Korea

8Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

*These authors contributed equally to this work

Correspondence to:

Cheolwon Suh, email: csuh@amc.seoul.kr

Dok Hyun Yoon, email: dhyoon@amc.seoul.kr

Keywords: beta 2-microglobulin, diffuse large B-cell lymphoma, rituximab, prognosis, non-Hodgkin lymphoma

Received: July 22, 2016     Accepted: October 12, 2016     Published: October 18, 2016

ABSTRACT

The prognostic value of serum beta-2 microglobulin for diffuse large B-cell lymphoma (DLBCL) is not well known in the rituximab era. A retrospective registry data analysis of 833 patients with de novo DLBCL treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) was conducted to establish the prognostic significance of serum beta-2 microglobulin at a ≥2.5 mg/L cutoff. Five-year progression-free survival (PFS, 76.1% vs. 41.0%; p < 0.001) and overall survival (OS, 83.8% vs. 49.2%; p < 0.001) were significantly worse in patients with elevated serum beta-2 microglobulin (n = 290, 34.8%). Furthermore, the five parameters of the International Prognostic Index, accompanying B symptoms, bone marrow involvement and impaired renal function were associated with worse PFS and OS. In multivariate analysis, elevated beta-2 microglobulin was a significant poor prognostic factor for PFS (hazard ratio [HR], 1.70; 95% confidence interval [CI], 1.29–2.24; p < 0.001) and OS (HR, 2.0; 95% CI, 1.47–2.75; p < 0.001). In an independent validation cohort of 258 R-CHOP treated patients with de novo DLBCL, elevated beta-2 microglobulin levels remained a significant poor prognostic factor for PFS (HR, 2.03; 95% CI, 1.23–3.32; p = 0.005) and exhibited a strong trend of association with worse OS (HR, 1.64; 95% CI, 0.98–2.75; p = 0.062). The significance of serum beta-2 microglobulin levels as an independent prognostic factor for patients with DLBCL receiving R-CHOP is confirmed.


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