Prognostic Stratification of Patients with Burkitt Lymphoma Using Serum β2-microglobulin Levels

• Published in: Cancer research and treatment Vol. 53; no. 3; pp. 847 - 856
• Main Authors: Kim, Hyung-Don, Cho, Hyungwoo, Kim, Shin, Lee, Kyoungmin, Kang, Eun Hee, Park, Jung Sun, Park, Chan-Sik, Huh, Jooryung, Ryu, Jin Sook, Lee, Sang-Wook, Yoon, Dok-Hyun, Kim, Seok Jin, Ko, Young Hyeh, Kim, Won Seog, Suh, Cheolwon
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Cancer Association 01.07.2021; 대한암학회
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; beta 2-Microglobulin - blood; Biomarkers, Tumor - blood; Burkitt Lymphoma - blood; Burkitt Lymphoma - drug therapy; Burkitt Lymphoma - mortality; Female; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Original; Predictive Value of Tests; Prognosis; Progression-Free Survival; Prospective Studies; Retrospective Studies; Risk Assessment - methods; Risk Factors; Survival Rate; Young Adult; 의학일반; Prognosis; β2-microglobulin; Burkitt lymphoma; Risk stratification
• ISSN: 1598-2998; 2005-9256; 2005-9256
• DOI: 10.4143/crt.2020.1060

Purpose We aimed to investigate the prognostic value of serum β2-microglobulin for patients with Burkitt lymphoma (BL) and to propose a risk-stratifying classification system.Materials and Methods A prospective registry-based cohort study of BL patients treated with dose-intensive or effective dose-adjusted chemotherapies (n=81) was conducted. Survival outcomes were compared based on previously reported risk groups and/or serum β2-microglobulin levels. A risk-stratifying classification system incorporating serum β2-microglobulin levels was proposed and validated in an independent validation cohort (n=60).Results The median age was 47 years, and 57 patients (70.4%) were male. Patients with high serum β2-microglobulin levels (> 2 mg/L) had significantly worse progression-free survival (PFS) and overall survival (OS) (p < 0.01 for both). Serum β2-microglobulin levels further stratified patients in the low-risk and high-risk groups in terms of PFS (p=0.010 and p=0.044, respectively) and OS (p=0.014 and p=0.026, respectively). Multivariate analyses revealed that a high serum β2-microglobulin level (> 2 mg/L) was independently associated with a shorter PFS (hazards ratio [HR], 3.56; p=0.047) and OS (HR, 4.66; p=0.043). The new classification system incorporating the serum β2-microglobulin level allowed the stratification of patients into three distinct risk subgroups with 5-year OS rates of 100%, 89.5%, and 62.5%. In an independent cohort of BL, the system was validated by stratifying patients with different survival outcomes.Conclusion Serum β2-microglobulin level is an independent prognostic factor for BL patients. The proposed β2-microglobulin–based classification system could stratify patients with distinct survival outcomes, which may help define appropriate treatment approaches for individual patients.