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Difference - beta globulin & beta-2 microglobulin (b2m)?

by Lisa B. on Tue Nov 08, 2011 3:46 pm

Hi Everyone,

My 71 yr. old mother was recently diagnosed with multiple myeloma (IgG lambda w/ FISH detected 13 monosomy & t (4;14). She also has SLE (systemic lupus) that has been largely inactive for years. I've been trying to educate myself as much as possible and this site has been immensely helpful!

However, I've obtained copies of her initial labwork and am confused about the difference/correlation between beta globulin and beta-2 microglobulin. Her results thus far only list a value for beta globulin, which is 6.4 (normal range 0.5 -1.1). I'm not even sure of the units of measurement since they're not included with the report.

Can anyone help me better understand this?

Following are some of her other test results:

LDH - normal @ 195
Albumin - Borderline low @ 3.4
M- Spike - Not reported??
Lambda FLC - 195.26
Kappa FLC - 17.2
K/L ration - 0.09
21% Plasma cell burden
Low HGB @ 9.3
No bone metastases

I appreciate any help/input! The members of this forum are absolutely amazing and inspiring! You are all lifted in my prayers!

- Lisa

Lisa B.
Name: Lisa B.
Who do you know with myeloma?: My mother, Barbara Henson
When were you/they diagnosed?: 10-28-11
Age at diagnosis: 71

Re: Difference - beta globulin & beta-2 microglobulin (b2m)?

by Dr. Adam Cohen on Thu Nov 10, 2011 9:52 am

Lisa,

The beta globulin is one of the values reported from a test called protein electrophoresis, which can be run on the blood (called serum protein electrophoresis - SPEP) or the urine (UPEP). The SPEP and UPEP are used to measure the level of the myeloma protein (called M-spike or M-protein) in blood and urine, respectively. They look at all the proteins in the blood or urine and divide them up into different components (albumin, alpha-1-globulins, alpha-2-globulins, beta globulins, gamma globulins) based on their characteristics. The levels of the individual components are not that important - what's important is if an M-spike is found and what that level is.

Sometimes a clear M-spike can't be seen or measured from the SPEP or UPEP. In that case we often use other tests such as the serum free light chains or immunoglobulin levels (e.g. IgG or IgA level) to measure the amount of myeloma protein present. I would suggest asking her oncologist what her M-spike is as well as what her IgG level is.

The beta-2-microglobulin is a completely different test run on the blood. It isn't a direct measure of the myeloma protein but gives some prognostic information and is part of the new International Staging System (ISS) for myeloma. If the beta-2-microglobulin is above 5.5 that indicates ISS stage 3 disease (the highest stage), and is suggestive of a somewhat more aggressive course.

Hope this is helpful.
Dr. Adam Cohen
Abramson Cancer Center, University of Pennsylvania

Any advice provided in these postings is based on a very limited amount of information. There is no substitute for the care of your oncologist/hematologist. Therefore, all suggestions should be discussed with your treating physician. None of the comments presented here are meant to replace the evaluation of a patient by a knowledgeable physician.


Dr. Adam Cohen
Name: Adam D. Cohen, M.D.
Beacon Medical Advisor

Re: Difference - beta globulin & beta-2 microglobulin (b2m)?

by Lisa B. on Thu Nov 10, 2011 11:57 am

Dear Dr. Cohen,

Your reply is IMMENSELY helpful!!! Based on internet searches, I had assumed that beta globulin and beta-2 microglobulin were measured differently and had different ranges, but I could find no clear confirmation or explanation as to why! I even called her oncology practice and the nurses (though very kind and helpful) could not even begin to answer my question.

I've only met with Mom's hematologist once, as she was diagnosed within just the past couple of weeks, but this also explains why, when I asked about B2M, he responded that her IgG level was 5.5. Does this have any prognostic value?

Her SPEP test results have "..." listed in the column for M-Spike and "PRESENT" listed in the column for abnormal protein band. We already know that she has high risk cytogenetics by FISH analysis detection of monosomy for 13 & (4;14) translocation, however, she is in excellent overall health with anemia as her only symptom and a very positive attitude!

If someone has the time and could comment on the significance of an IgG of 5.5 I would appreciate it, and please know that I cannot even find words adequate to express my gratitude for "The Myeloma Beacon"!!! What a wonderful resource and blessing for those of us who find ourselves or our loved ones suddenly and unexpectedly thrown into the world of Myelomaville. It is definitely NOT where we would choose to reside, but I'm finding that our "neighbors" can't be beat!!! =)

With utmost respect and gratitude,

Lisa

Added on 11-11-11: I think I've figured it out! Kept finding values for IgG reported in mg/dL, so I was confused about the numbers because they were all in the thousands, but the value of 5.5 that Mom's Dr. reported must be in g/dL! I also found a Durie-Salmon Classification chart that listed values for the individual Ig values, and according to that, Mom's "5.5" falls somewhere between Stage 1 & Stage 3, as do most of her other values. Based on that, she must be in Stage 2 on the Durie-Salmon scale. I hope this is correct!
Last edited by Lisa B. on Fri Nov 11, 2011 5:30 pm, edited 1 time in total.

Lisa B.
Name: Lisa B.
Who do you know with myeloma?: My mother, Barbara Henson
When were you/they diagnosed?: 10-28-11
Age at diagnosis: 71

Re: Difference - beta globulin & beta-2 microglobulin (b2m)?

by Kansas on Thu Nov 10, 2011 11:08 pm

I've alread read that the beta-2-microglobulin number may be higher if you have kidney issues, so if you have no M spike and all indicatiaons of therapy put the patient in complete remission, the beta -2 microglobulin could be attributed to the kidney involvement?

I think this is a question, but I also think it may be a correct statement. Please correct me if I'm wrong.

Thanks

Kansas
Name: Rex
Who do you know with myeloma?: self
When were you/they diagnosed?: May 2010
Age at diagnosis: 61

Re: Difference - beta globulin & beta-2 microglobulin (b2m)?

by Dr. Adam Cohen on Sun Nov 13, 2011 10:47 pm

Lisa - you are correct that it would be Durie-Salmon Stage 2.

Kansas - you are also correct that beta-2 microglobulin is cleared by the kidney. So it can some­times be elevated in patient with chronic kidney failure, even if his/her myeloma is in remission.
Dr. Adam Cohen
Abramson Cancer Center, University of Pennsylvania

Any advice provided in these postings is based on a very limited amount of information. There is no substitute for the care of your oncologist/hematologist. Therefore, all suggestions should be discussed with your treating physician. None of the comments presented here are meant to replace the evaluation of a patient by a knowledgeable physician.


Dr. Adam Cohen
Name: Adam D. Cohen, M.D.
Beacon Medical Advisor


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