Cancer Res Treat.  2021 Jul;53(3):847-856. 10.4143/crt.2020.1060.

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

• Kim HD
• Cho H
• Kim S
• Lee K
• Kang EH
• Park JS
• Park CS
• Huh J
• Ryu JS
• Lee SW
• Yoon DH
• Kim SJ
• Ko YH
• Kim WS
• Suh C

• KMID: 2518409
• DOI: http://doi.org/10.4143/crt.2020.1060

Abstract

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.

Keyword

Burkitt lymphoma; β2-microglobulin; Prognosis; Risk stratification

Figure

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  Fig. 1 Survival outcomes according to risk groups and serum β2-microglobulin (B2M) levels: progression-free survival and overall survival according to risk groups (A) and serum B2M levels (B).

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  Fig. 2 Survival outcomes of patients with different serum β2-microglobulin (B2M) levels in different risk groups. Progression-free survival and overall survival according to the serum B2M levels in the low-risk group (A) and high-risk group (B). (C) Survival outcomes were compared between low-risk group patients with serum B2M levels of > 2.0 mg/L and high-risk group patients.

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  Fig. 3 Survival outcomes in subgroups determined by a novel serum β2-microglobulin (B2M)–based risk stratification system. Progression-free survival and overall survival of low-risk group patients with serum B2M levels of ≤ 2 mg/L, high-risk group patients with serum B2M levels of ≤ 2 mg/L, and any-risk group patients with serum B2M levels of > 2 mg/L in the training cohort (A) and validation cohort (B).

Reference

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