Annals of Hematology

, Volume 91, Issue 8, pp 1265–1270 | Cite as

Serum beta2-microglobin is a predictor of prognosis in patients with upper aerodigestive tract NK/T-cell lymphoma

  • Zhi-Ming Li
  • Ying-Jie Zhu
  • Jian Sun
  • Yi Xia
  • Jia-Jia Huang
  • Ben-Yan Zou
  • Tong-Yu Lin
  • Hui-Qiang Huang
  • Wen-Qi Jiang
Original Article


Upper aerodigestive tract natural killer (NK)/T-cell lymphoma (UNKTL) is the most common type of extranodal NK/T-cell lymphoma, nasal type. Serum beta2-microglobulin (β2-M) was found to be a predictor in some subtypes of B-cell lymphoma. However, its prognostic significance in NK/T-cell lymphoma has never been explored. We retrospectively analyzed 82 patients newly diagnosed as UNKTL. Serum β2-M was detected prior to treatment in this series. Various statistical analyses were performed to evaluate the significance of the relevant clinical parameters. High serum β2-M level was calculated as ≥2.5 mg/L by the median value. The number of patients with serum β2-M ≥2.5 mg/L at diagnosis was 39 (47.6%) and 43 patients (52.4%) with β2-M <2.5 mg/L. Patients with high serum β2-M level at diagnosis seemed to have more adverse clinical features: B symptoms (p = 0.007) and elevated LDH level (p < 0.001), and high KPI score (p = 0.002). Serum β2-M ≥2.5 mg/L was significantly associated with poor overall survival (5-year OS, 35.2% vs 73.6%; p = 0.001) and progression-free survival (5-year PFS, 27.5% vs 55.9%; p = 0.028). For patients with early stage, serum β2-M at diagnosis could also help to distinguish those with favorable outcomes from those with poor outcomes. In multivariate analysis, high serum β2-M level remained its prognostic impact on survival (OS: p = 0.002; PFS: p = 0.039), independent of the International Prognostic Index score. Our study suggested high serum β2-M was a novel predictor of prognosis in patients with UNKTL. A simply and regular way might be established to identify UNKTL patients of different risks at diagnosis.


Beta2-microglobulin Prognosis Upper aerodigestive tract NK/T-cell lymphoma 



This work was supported by National Natural Science Foundation of China (NO. 30400589, 81071950), Fundamental Research Funds for the Central Universities (NO. 10ykpy36), National-Eleventh Five Technology Major Project (NO. 2008ZX09312-002, 2012ZX09301), and Research Award Funds for Outstanding Young Researchers in Sun Yat-sen Cancer Center. The authors thank the patients and their families and all the investigators, including the physicians, nurses, and laboratory technicians in this study.

Conflict of interest

The authors have no conflicts of interest.


  1. 1.
    Lee J, Suh C, Park YH et al (2006) Extranodal natural killer T-cell lymphoma, nasal-type: a prognostic model from a retrospective multicenter study. J Clin Oncol 24:612–618PubMedCrossRefGoogle Scholar
  2. 2.
    Sabattini E, Bacci F, Sagramoso C et al (2010) WHO classification of tumours of haematopoietic and lymphoid tissues in 2008: an overview. Pathologica 102:83–87PubMedGoogle Scholar
  3. 3.
    Vose J, Armitage J, Weisenburger D (2008) International peripheral T-cell and natural killer/T-cell lymphoma study: pathology findings and clinical outcomes. J Clin Oncol 26:4124–4130PubMedCrossRefGoogle Scholar
  4. 4.
    Au WY, Ma SY, Chim CS et al (2005) Clinicopathologic features and treatment outcome of mature T-cell and natural killer-cell lymphomas diagnosed according to the World Health Organization classification scheme: a single center experience of 10 years. Ann Oncol 16:206–214PubMedCrossRefGoogle Scholar
  5. 5.
    Au WY, Weisenburger DD, Intragumtornchai T et al (2009) International Peripheral T-Cell Lymphoma Project. Clinical differences between nasal and extranasal natural killer/T-cell lymphoma: a study of 136 cases from the International Peripheral T-Cell Lymphoma Project. Blood 113:3931–3937PubMedCrossRefGoogle Scholar
  6. 6.
    Kim TM, Park YH, Lee SY et al (2005) Local tumor invasiveness is more predictive of survival than International Prognostic Index in stage I(E)/II(E) extranodal NK/T-cell lymphoma, nasal type. Blood 106:3785–3790PubMedCrossRefGoogle Scholar
  7. 7.
    Lee J, Kim WS, Park YH et al (2005) Nasal-type NK/T cell lymphoma: clinical features and treatment outcome. Br J Cancer 92:1226–1230PubMedCrossRefGoogle Scholar
  8. 8.
    Lee J, Park YH, Kim WS et al (2005) Extranodal nasal type NK/T-cell lymphoma: elucidating clinical prognostic factors for risk-based stratification of therapy. Eur J Cancer 41:1402–1408PubMedCrossRefGoogle Scholar
  9. 9.
    Chim CS, Ma SY, Au WY et al (2004) Primary nasal natural killer cell lymphoma: long-term treatment outcome and relationship with the International Prognostic Index. Blood 103:216–221PubMedCrossRefGoogle Scholar
  10. 10.
    You JY, Chi KH, Yang MH et al (2004) Radiation therapy versus chemotherapy as initial treatment for localized nasal natural killer (NK)/T-cell lymphoma: a single institute survey in Taiwan. Ann Oncol 15:618–625PubMedCrossRefGoogle Scholar
  11. 11.
    Huang JJ, Jiang WQ, Lin TY et al (2011) Absolute lymphocyte count is a novel prognostic indicator in extranodal natural killer/T-cell lymphoma, nasal type. Ann Oncol 22:149–155PubMedCrossRefGoogle Scholar
  12. 12.
    Kim HS, Kim KH, Kim KH et al (2009) Whole blood Epstein–Barr virus DNA load as a diagnostic and prognostic surrogate: extranodal natural killer/T-cell lymphoma. Leuk Lymphoma 50:757–763PubMedCrossRefGoogle Scholar
  13. 13.
    Martayan A, Sibilio L, Tremante E et al (2009) Class I HLA folding and antigen presentation in beta 2-microglobulin-defective Daudi cells. J Immunol 182:3609–3617PubMedCrossRefGoogle Scholar
  14. 14.
    Bouvier M (2003) Accessory proteins and the assembly of human class I MHC molecules: a molecular and structural perspective. Mol Immunol 39:697–706PubMedCrossRefGoogle Scholar
  15. 15.
    Munshi NC, Anderson KC, Bergsagel PL et al (2011) Consensus recommendations for risk stratification in multiple myeloma: report of the International Myeloma Workshop Consensus Panel 2. Blood 117:4696–4700PubMedCrossRefGoogle Scholar
  16. 16.
    Dimopoulos M, Kyle R, Fermand JP et al (2011) Consensus recommendations for standard investigative workup: report of the International Myeloma Workshop Consensus Panel 3. Blood 117:4701–4705PubMedCrossRefGoogle Scholar
  17. 17.
    Antic D, Mihaljevic B, Cokic V et al (2011) Patients with early stage chronic lymphocytic leukemia: new risk stratification based on molecular profiling. Leuk Lymphoma 52:1394–1397PubMedCrossRefGoogle Scholar
  18. 18.
    Chronowski GM, Wilder RB, Tucker SL et al (2002) An elevated serum beta-2-microglobulin level is an adverse prognostic factor for overall survival in patients with early-stage Hodgkin disease. Cancer 95:2534–2538PubMedCrossRefGoogle Scholar
  19. 19.
    Federico M, Bellei M, Marcheselli L et al (2009) Follicular lymphoma international prognostic index 2: a new prognostic index for follicular lymphoma developed by the international follicular lymphoma prognostic factor project. J Clin Oncol 27:4555–4562PubMedCrossRefGoogle Scholar
  20. 20.
    Federico M, Guglielmi C, Luminari S et al (2007) Prognostic relevance of serum beta2 microglobulin in patients with follicular lymphoma treated with anthracycline-containing regimens. A GISL study. Haematologica 92:1482–1488PubMedCrossRefGoogle Scholar
  21. 21.
    Rodríguez J, Conde E, Gutiérrez A et al (2007) The adjusted International Prognostic Index and beta-2-microglobulin predict the outcome after autologous stem cell transplantation in relapsing/refractory peripheral T-cell lymphoma. Haematologica 92:1067–1074PubMedCrossRefGoogle Scholar
  22. 22.
    Moore DF Jr, Cabanillas F (1998) Overview of prognostic factors in non-Hodgkin’s lymphoma. Oncology (Williston Park) 12:17–24Google Scholar
  23. 23.
    Cheson BD, Horning SJ, Coiffier B et al (1999) Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. NCI Sponsored International Working Group. J Clin Oncol 17:1244PubMedGoogle Scholar
  24. 24.
    Pagano L, Gallamini A, Trapè G et al (2006) NK/T-cell lymphomas ‘nasal type’: an Italian multicentric retrospective survey. Ann Oncol 17:794–800PubMedCrossRefGoogle Scholar
  25. 25.
    Suki S, Swan F Jr, Tucker S et al (1995) Risk classification for large cell lymphoma using lactate dehydrogenase, beta-2 microglobulin, and thymidine kinase. Leuk Lymphoma 18:87–92PubMedCrossRefGoogle Scholar
  26. 26.
    Huang WC, Wu D, Xie Z et al (2006) beta2-microglobulin is a signaling and growth-promoting factor for human prostate cancer bone metastasis. Cancer Res 66:9108–9116PubMedCrossRefGoogle Scholar
  27. 27.
    Nomura T, Huang WC, Seo S et al (2007) Targeting beta2-microglobulin mediated signaling as a novel therapeutic approach for human renal cell carcinoma. J Urol 178:292–300PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Zhi-Ming Li
    • 1
  • Ying-Jie Zhu
    • 1
  • Jian Sun
    • 1
  • Yi Xia
    • 1
  • Jia-Jia Huang
    • 1
  • Ben-Yan Zou
    • 1
  • Tong-Yu Lin
    • 1
  • Hui-Qiang Huang
    • 1
  • Wen-Qi Jiang
    • 1
  1. 1.State Key Laboratory of Oncology in Southern China, Department of Medical OncologySun Yat-sen University Cancer CenterGuangzhouChina

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