Beta-2-Microglobulin (Beta-2-M), Serum
Prognosis assessment of multiple myeloma
Evaluation of renal tubular disorders
Testing Algorithm Delineates situation(s) when tests are added to the initial order. This includes reflex and additional tests.
See Laboratory Screening Tests for Suspected Multiple Myeloma in Special Instructions.
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Beta-2-microglobulin (beta-2-M) is a small membrane protein (11,800 Dalton) associated with the heavy chains of class I major histocompatibility complex proteins and is, therefore, on the surface of all nucleated cells. The small size allows beta-2-M to pass through the glomerular membrane, but it is almost completely reabsorbed in the proximal tubules.
Serum beta-2-M levels are elevated in diseases associated with increased cell turnover. Levels are also elevated in several benign conditions such as chronic inflammation, liver disease, renal dysfunction, some acute viral infections, and a number of malignancies, especially hematologic malignancies associated with the B-lymphocyte lineage.
In multiple myeloma, beta-2-M is a powerful prognostic factor and values <4 mcg/mL are considered a good prognostic factor.
In renal tubular disease, serum levels are low and urine levels are high. Although urine beta-2-M has been used to assess tubular dysfunction, it is not stable in urine below pH 5.5.
See Diagnosis and Monitoring of Multiple Myeloma in Publications. Also see Laboratory Screening Tests for Suspected Multiple Myeloma in Special Instructions.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Serum beta-2-microglobulin (beta-2-M) <4 mcg/mL is a good prognostic factor in patients with multiple myeloma. In a study of pretreatment serum beta-2-M levels in 100 patients with myeloma it was reported that the median survival of patients with values >4 mcg/mL was 12 months, whereas median survival for patients with values <4 mcg/mL was 43 months.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Bataille R, Magub M, Grenier J, et al: Serum beta-2-microglobulin in multiple myeloma: Relation to presenting features and clinical status. Eur J Cancer Clin Oncol 1982;18:59-66
2. Garewal H, Durie BG, Kyle RA, et al: Serum beta-2-microglobulin in the initial staging and subsequent monitoring of monoclonal plasma cell disorders. J Clin Oncol 1984;2:51-57
3. Norfolk D, Child JA, Cooper EH, et al: Serum beta-2-microglobulin in myelomatosis: potential value in stratification and monitoring. Br J Cancer 1980;42:510-550
4. Dolan MJ, Lucey DR, Hendrix CW, et al: Early markers of HIV infection and subclinical disease progression. Vaccine 1993;11:548-551
5. Karlsson FA, Wibell L, Evrin PE: Beta-2-microglobulin in clinical medicine. Scand J Clin Lab Invest 1986;154:27-37
6. Greipp PR, Katzmann JA, O'Fallon WM, Kyle RA: Value of beta-2-microglobulin level and plasma cell labeling indices as prognostic factors in patients with newly diagnosed myeloma. Blood 1988;72:219-223