[dw10018]

B2 microglobulin

by dw10018 on Thu May 26, 2011 2:17 pm

Drs, Vesole and Siegel,
I'm an IGA patient and I have two questions. First regarding B2 microglobulin numbers. My B2's are in the normal range, but during my past four monthly blood/lab results, as my kappa light chain numbers have decreased my B2 have increased and during the times when the kappa's are up the B2 is down. This seems counterintuitive. My oncologist can't explain it. This seems to coincide with staring the combo of vel/rev/dex. Which leads to my second question, since I've been on this combo my liver enzymes have climbed, currently, bili total 1.8, direct 0.2, indirect 1.6, AST 54, ALT 168. When just on rev or vel alone never had this problem. Since I've been on an extended break from chemo, my oncologist is running another hepatic panel, could this be a Vel issue? Doesn’t dex also increase liver enzymes? I’ve been on dex for over three years.

Thanks again for your help!

Dean

[Dr. David Siegel]

Re: B2 microglobulin

by Dr. David Siegel on Thu May 26, 2011 4:58 pm

You are asking lots of tough questions.

First it should be recognized that B2M is not a true tumor marker. Anything that causes inflammation or effects renal function will effect the B2M. If you are getting a hepatitis while being treated that alone is enough to explain this.

You are right about the drugs. Basically all of them can cause LFT abnormalities. Steroids in particular will cause a "fatty liver"

[Joel Smith,MD]

Re: B2 microglobulin

by Joel Smith,MD on Sun Jun 05, 2011 7:23 am

Recognizing the validity of the B2M explanation above, If a patient has consistently low values, is this not a valuable tumor marker / response ?

[Dr. Edward Libby]

Re: B2 microglobulin

by Dr. Edward Libby on Fri Jun 10, 2011 11:20 am

Yes. Consistently low values are a favorable finding.