Beta 2 microgloblin increase prognosis effectiveness in aggressive diffuse large b-cell lymphoma and high clinical risk

Abstract

Introduction: We conducted an open label clinical to assess if beta 2 microglobulin (B2M) can be useful as prognostic factor that can increase the usefulness of International Prognostic Index (IPI)in patients with aggressive lymphoma ; with stage IV and high clinical risk. Methods: Between January 1999 to December 2015, 1388 patients with aggressive lymphoma ,in that were classified as high-clinical risk and stage IV, treated with CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) or R-CHOP (CHOP+rituximab); B2M was adding to the staging procedures; they were classified in two groups: normal (< 3.0 mg/L) or elevated ( >3.0 mg/L) levels that were compared in response type and outcome. Results: Complete response, actuarial curves of progression-free survival and overall survival, were statistically better in patients with normal levels of B2M: 68%; 78% (95% Confidence interval(CI):(69% - 83%)) and 73%(95%CI: 67%-82 %) ; and 73% (95%CI:67%-81%) compared with patients with high levels were: 54%; 58%(95%CI; 48%-67%); and 47% (95%CI:39%-58%), (p <0.001) respectively. Multivariable analysis confirm that B2M and lactate dehydrogenase have powerful to detect a worse prognostic course. Conclusion: B2M appear to be a no-expensive, simple and reproducible marker to help defined an worse prognosis in patients with high clinical risk and advanced stage. Thus, will be considered to planned a clinical trial to test the efficacy of different chemotherapeutic regimens in these setting of patients.