Prognostic value of serum β2-microglobulin in patients with Waldenstrom's macroglobulinemia requiring treatment

Purpose: Waldenstrom's macroglobulinemia (WM) is a lymphoplasmacytoid lymphoma characterized by a relatively indolent course with median survival ranging from 5 years to 10 years in different series. Several clinical and laboratory variables have been associated with inferior survival, such as advanced age, hyperviscosity, presence of cytopenia, and hypoalbuminemia. Recent data indicate that serum beta(2)-microglobulin (beta 2M) might also be significant. The purpose of our study was to assess possible correlations of beta 2M with clinical and laboratory variables and to further evaluate its association with cause-specific and overall survival (OS) of patients with WM requiring treatment. Patients and Methods: We analyzed 124 patients with WM with an available pretreatment value of beta 2M. Median age was 70 years (range, 28-89 years), and median survival was 105 months. Multiple clinical and laboratory parameters were evaluated for their possible correlation with OS. Results: Patients with older age, anemia, thrombocytopenia, hypoalbuminemia, and higher creatinine levels had significantly greater serum beta 2M levels. This variable was associated with impaired cause-specific survival and OS in the whole group of patients and in patients aged <= 70 years. More specifically, OS for all patients according to serum beta 2M > 4 mg/dL versus <= 4 mg/dL was 79 months versus 115 months (P = 0.01). Conclusion: Our data provide further evidence that high beta 2M levels are an important parameter associated with inferior OS and cause-specific survival of patients with WM requiring treatment. This parameter may be used to stratify patients involved in prospective clinical trials.