[RadiantTiger]

Importance of beta-2 microglobulin and albumin levels?

by RadiantTiger on Tue Apr 07, 2015 5:26 pm

I'm confused about the importance of beta-2 microglobulin and albumin levels.

According to the 'International Staging System', these numbers are used to indicate prognosis.

I am starting round 4 of induction treatment. I was told today that these numbers aren't that important for tracking the success of your treatment. They were looking mostly at my M-Spike, kappa free light chains and kappa / lambda ratio (which fortunately show dramatic declines after 6 weeks on treatment!). My clinic used the 'Durie-Salmon' staging system, which uses different indicators for staging. (At diagnosis, I was a Stage II, according to both staging systems.)

So is it the case that some doctors think they are important, and others don't? Or is it that they are important just at diagnosis, but not after treatment?

RT

[Multibilly]

Re: Importance of beta-2 microglobulin and albumin levels?

by Multibilly on Tue Apr 07, 2015 6:08 pm

Hey Radiant Tiger,

See Dr. Libby's comments in the forum discussion "Beta 2 microglobulin" (started March 8, 2015).

In general, there is no reason to get the beta-2 microglobulin test after the initial diagnosis of multiple myeloma is made. The only time it has significant value is at diagnosis to de­ter­mine the patient's stage. As you may know, the International Staging System for myeloma (ISS) uses two blood measurements – the albumin level, and the beta-2 microglobulin level – to de­ter­mine a patient's stage at diagnosis.

After determining a patient's stage at diagnosis, the beta-2 microglobulin is really not very use­ful. I generally do not repeat it after making the initial diagnosis of myeloma. Some research studies may require it, and many physicians do obtain it, but, from my perspective, the really useful tests that tell us how a patient's myeloma is doing are your SPEP, serum free light chains, and UPEP.

Although I get my beta2 microglobulin measured every few months, my local onc generally agrees with Dr. Libby.

[RadiantTiger]

Re: Importance of beta-2 microglobulin and albumin levels?

by RadiantTiger on Tue Apr 07, 2015 7:13 pm

Multibilly,

Thanks for the link. Interesting that something so important at diagnosis is unimportant after treatment starts.

RT

[AnnaF]

Re: Importance of beta-2 microglobulin and albumin levels?

by AnnaF on Tue Apr 07, 2015 7:18 pm

Hi there,

My dad is a patient of Dr. Libby's, and I actually just had this conversation with Dr. Libby's assistant. While the beta-2 and albumin are indeed used for staging, the albumin in particular can jump around dramatically over the course of a few days. For example, if you have a cold, your albumin may drop from a 4.0 to a 3.0, which would seem terrifying, as that would move one from a Stage 1 to a Stage 3. However, this should not be taken too seriously as an indicator of anything more than one's general health on the day the blood was drawn.

From my understanding, what you want to focus on are overall trends, and particularly the M-spike and kappa / lambda ratio, which show how much cancer is in your body. The staging appears to be too mercurial and subjective according to other factors to focus on too heavily.