A new serologic staging system for large-cell lymphomas based on initial β2-microglobulin and lactate dehydrogenase levels

We report results of our investigation of prognostic factors for patients with large-cell lymphoma who were entered on the same treatment protocol and who had known pretreatment serum β2-micorglobulin (β2M) and lactate dehydrogenase (LDH) levels. β2M and LDH levels were the most significant and independent variables for predicting time to treatment failure (TTF) and survival. The serum level of β2M correlated with tumor burden. These two serum markers defined three significantly different prognostic groups. All 27 patients in the low-risk group remain alive and in remission; in contrast, 22 of the 27 patients (81%) in the high-risk group have failed treatment, and only seven (26%) remain alive. In comparison with the Ann Arbor staging system, serum levels of β2M and LDH may provide a more precise system for defining risk grojups and thereby allow a more rational approach to the development and analysis of treatment strategies.