Litam P, Swan F, Cabanillas F, Tucker S L, McLaughlin P, Hagemeister F B, Rodriguez M A, Velasquez W S
University of Texas M.D. Anderson Cancer Center, Houston.
Ann Intern Med. 1991 May 15;114(10):855-60. doi: 10.7326/0003-4819-114-10-855.
To evaluate serum beta-2 microglobulin (beta-2M) and other prognostic indicators in previously untreated low-grade lymphoma.
Cohort study of 80 patients with uniformly treated low-grade lymphoma, followed for a median of 21 months. These 80 patients, all of whom had serum beta-2M drawn within 2 weeks before starting therapy, were derived from a cohort of 119 previously untreated patients entered into one of three clinical trials.
Tertiary referral cancer center.
Eighty previously untreated stage I to IV patients (mean age, 55 years).
Treatment was given according to Ann Arbor stage: Patients in stage IV were treated with CHOP-bleomycin and maintained on interferon therapy; those in stage III received CHOP-bleomycin and radiotherapy; and those in stages I and II received COP-bleomycin and radiotherapy.
Outcome was determined by assessing complete remission rate and time to treatment failure. Univariate and multivariate analyses were used.
The complete remission rate for patients with a beta-2M level of 3.0 mg/L or greater was 36% compared with 71% for those with a level of less than 3.0 mg/L. Using multivariate analysis that tested beta-2M as a continuous variable, it was selected as the most significant factor for complete response. The adjusted odds ratio was 0.285 (95% CI, 0.101 to 0.809). The Ann Arbor stage had marginal significance (adjusted odds ratio, 0.435; CI, 0.150 to 1.263). For time to treatment failure, beta-2M was the only variable retained in the multivariate model. At 42 months, no patient with a beta-2M level of 3.0 mg/L or greater was projected to be in remission as compared with 85% of patients with a beta-2M level of less than 3.0 mg/L.
The serum beta-2M level is a good predictor of complete response and time to treatment failure. A larger number of patients should be studied to clarify the role of other potentially independent variables such as stage and age.
评估血清β2微球蛋白（β2M）及其他预后指标在初治低度淋巴瘤中的情况。
对80例接受统一治疗的低度淋巴瘤患者进行队列研究，中位随访时间为21个月。这80例患者均在开始治疗前2周内检测了血清β2M，他们来自119例初治患者组成的队列，这些患者参与了三项临床试验中的一项。
三级转诊癌症中心。
80例初治的Ⅰ至Ⅳ期患者（平均年龄55岁）。
根据Ann Arbor分期进行治疗：Ⅳ期患者接受CHOP-博来霉素方案治疗并接受干扰素维持治疗；Ⅲ期患者接受CHOP-博来霉素方案治疗及放疗；Ⅰ期和Ⅱ期患者接受COP-博来霉素方案治疗及放疗。
通过评估完全缓解率和治疗失败时间来确定结局。采用单因素和多因素分析。
β2M水平≥3.0mg/L的患者完全缓解率为36%，而β2M水平＜3.0mg/L的患者完全缓解率为71%。在将β2M作为连续变量进行检验的多因素分析中，它被选为完全缓解的最显著因素。调整后的优势比为0.285（95%可信区间，0.101至0.809）。Ann Arbor分期具有边缘显著性（调整后的优势比，0.435；可信区间，0.150至1.263）。对于治疗失败时间，β2M是多因素模型中唯一保留的变量。在42个月时，预计β2M水平≥3.0mg/L的患者无一人处于缓解状态，而β2M水平＜3.0mg/L的患者中有85%处于缓解状态。
血清β2M水平是完全缓解和治疗失败时间的良好预测指标。应研究更多患者以阐明其他潜在独立变量如分期和年龄的作用。
