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β2-Microglobulin

CPT: 82232
Updated on 01/29/2020
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Synonyms

  • Beta-2 Microglobulin, Serum

Special Instructions

Values obtained with different assay methods should not be used interchangeably in serial testing. It is recommended that only one assay method be used consistently to monitor each patient's course of therapy. This procedure does not provide serial monitoring; it is intended for one-time use only. If serial monitoring is required, please use the serial monitoring number 480020 to order.

Values obtained with different assay methods should not be used interchangeably in serial testing. It is recommended that only one assay method be used consistently to monitor each patient's course of therapy. This procedure does not provide serial monitoring; it is intended for one-time use only. If serial monitoring is required, please use the serial monitoring number 480020 to order.

Values obtained with different assay methods should not be used interchangeably in serial testing. It is recommended that only one assay method be used consistently to monitor each patient's course of therapy. This procedure does not provide serial monitoring; it is intended for one-time use only. If serial monitoring is required, please use the serial monitoring number 480020 to order.


Expected Turnaround Time

2 - 4 days


Related Documents


Specimen Requirements


Specimen

Serum


Volume

0.5 mL


Minimum Volume

0.3 mL (Note: This volume does not allow for repeat testing.)


Container

Red-top tube or gel-barrier tube


Collection

If a red-top tube is used, transfer separated serum to a plastic transport tube.


Storage Instructions

Refrigerate


Stability Requirements

Temperature

Period

Room temperature

7 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3


Test Details


Use

Evaluate the severity and prognosis of multiple myeloma, chronic lymphocytic leukemia, or non-Hodgkin's lymphoma; detect kidney damage and distinguish between glomerular and tubular kidney disorders.


Limitations

Drugs such as lithium, cyclosporine, cisplatin, carboplatin, and aminoglycoside antibiotics can increase β2-microglobulin concentrations.1


Methodology

Immunochemiluminometric assay (ICMA)


Reference Interval

See table.1

Age

Male (mg/L)

Female (mg/L)

0 to 1 m

1.6−4.8

1.7−4.5

1 to 6 m

1.4−3.3

1.0−3.8

7 to 11 m

0.9−3.1

1.0−2.3

1 to 3 y

0.8−2.2

0.7−2.4

4 to 6 y

0.6−2.3

0.5−2.2

7 to 9 y

0.8−1.7

0.7−1.8

10 to12 y

0.7−1.8

0.7−2.0

13 to 15 y

0.7−2.0

0.8−1.9

16 to 18 y

0.7−1.9

0.6−1.9

>18 y

0.6−2.4

0.6−2.4


Additional Information

β-2microglobulin (β2MG) is a small membrane protein that is a component of the class I major histocompatibility complex found on the surface of all nucleated cells.1 β2MG is especially abundant on the surface of white blood cells so increased production or destruction of these cells causes serum levels to increase.1 Levels of β2MG can be increased in patients with chronic inflammation, some viral infections, and in several hematologic malignancies associated with the β-lymphocyte lineage.1

Serum β2MG is often measured to assess the severity of multiple myeloma and Waldenström's macroglobulinemia and to monitor the effectiveness of treatment.2-4 Significantly elevated levels are associated with a poorer prognosis.2-4 Greipp and associates devised a simple calculation (the International Staging System) using serum β2MG and albumin for the classification and stratification of patients with multiple myeloma.3 The utility of this calculation has been reviewed along with the potential for enhancement by addition of other biomarkers.4 Measurement of serum β2MG is also helpful in patients with leukemia or lymphoma to help determine stage of disease and independent predict progression-free survival.5-10 β2MG levels also rise during infection with some viruses, including cytomegalovirus and human immunodeficiency virus.11,12

In the healthy kidney, β2MG passes through the glomeruli, and is then almost completely reabsorbed by the proximal tubules.1 In someone with signs of kidney disease, measurement of serum and urine β2MG can be useful in distinguishing between glomerular and tubular disfunction. Serum β2MG levels increase with the progression of chronic kidney disease.13 In patients on long-term hemodialysis, β2MG can aggregate into amyloid fibers that deposit in joints and tissues, causing stiffness and pain in a condition referred to as dialysis-related amyloidosis.13 Serum β2MG levels are a significant predictor of mortality in haemodialysis patients.14-17

Recently, serum β2MG has been shown to be an independent predictor of mortality in older adults.18 This study found that increased baseline serum β2MG was an independent predictor of increased cardiovascular events and cardiac mortality.18


Footnotes

1. Lab Tests Online. Beta-2 Microglobulin. Available at: http://www.labtestsonline.org/understanding/analytes/beta_microglob/related.html.
2. Kyle RA, Treon SP, Alexanian R, et al. Prognostic markers and criteria to initiate therapy in Waldenström's macroglobulinemia: Consensus panel recommendations from the Second International Workshop on Waldenström's Macroglobulinemia. Semin Oncol. 2003 Apr; 30(2):116-120. 12720119
3. Greipp PR, San Miguel J, Durie BG, et al. International staging system for multiple myeloma. J Clin Oncol. 2005 May 20; 23(15):3412-3420. 15809451
4. Kyrtsonis MC, Maltezas D, Tzenou T, Koulieris E, Bradwell AR. Staging systems and prognostic factors as a guide to therapeutic decisions in multiple myeloma. Semin Hematol. 2009 Apr; 46(2):110-117. 19389494
5. Molica S, Mauro FR, Callea V, et al. The utility of a prognostic index for predicting time to first treatment in early chronic lymphocytic leukemia: The GIMEMA experience. Haematologica. 2010 Mar; 95(3):464-469. 19903673
6. Tsimberidou AM, Wen S, O'Brien S, et al. Assessment of chronic lymphocytic leukemia and small lymphocytic lymphoma by absolute lymphocyte counts in 2,126 patients: 20 years of experience at the University of Texas M.D. Anderson Cancer Center. J Clin Oncol. 2007 Oct 10; 25(29):4648-4656. 17925562
7. Wierda WG, O'Brien S, Wang X, et al. Prognostic nomogram and index for overall survival in previously untreated patients with chronic lymphocytic leukemia. Blood. 2007 Jun 1; 109(11):4679-4685. 17299097
8. Jacobs P, Wood L. Chronic lymphocytic leukaemia—the haematologic basis for diagnosis and treatment. Hematology. 2002 Feb; 7(1):33-41. 12171775
9. Hallek M. Wanders L, Ostwald M, et al. Serum beta(2)-microglobulin and serum thymidine kinase are independent predictors of progression-free survival in chronic lymphocytic leukemia and immunocytoma. Leuk Lymphoma. 1996 Aug; (5-6):439-447. 8882957
10. Di Giovanni S, Valentini G, Carducci P, Giallonardo P. Beta-2-microglobulin is a reliable tumor marker in chronic lymphocytic leukemia. Acta Haematol. 1989; 81(4):181-185. 2502891
11. Matos AC, Durão MS Jr, Pacheco-Silva A. Serial beta-2 microglobulin measurement as an auxilliary method in the early diagnosis of cytomegalovirus infection in renal transplant patients. Transplant Proc. 2004 May; 36(4): 894-895. 15194307
12. Ullum H, Lepri AC, Katzenstein TL, et al. Prognostic value of single measurements of beta-2-microglobulin, immunoglobulin A in HIV disease after controlling for CD4 lymphocyte counts and plasma HIV RNA levels. Scand J Inject Dis. 2000; 32(4):371-376. 10959644
13. Winchester JF, Salsberg JA, Levin NW. Beta-2 microglobulin in ESRD: an in-depth review. Adv Ren Replace Ther. 2003 Oct; 10(4):279-309. 14681859
14. Drüeke TB, Massy ZA. Beta2-microglobulin. Semin Dial. 2009 Jul-Aug; 22(4):378-380. 19708985
15. Okuno S, Ishimura E, Kohno K, et al. Serum beta2-microglobulin level is a significant predictor of mortality in maintenance haemodialysis patients. Nephrol Dial Transplant. 2009 Feb; 24(2):571-577. 18799606
16. Cheung AK, Greene T, Leypoldt JK, et al. Association between serum 2-microglobulin level and infectious mortality in hemodialysis patients. Clin J Am Soc Nephrol. 2008 Jan; 3(1):69-77. 18057309
17. Cheung AK, Rocco MV, Yan G, et al. Serum beta-2 microglobulin levels predict mortality in dialysis patients: Results of the HEMO study. J Am Soc Nephrol. 2006 Feb; 17(2):546-555. 16382021
18. Kawai K, Kawashima S, Miyazaki T, et al. Serum beta2-microglobulin concentration as a novel marker to distinguish levels of risk in acute heart failure patients. J Cardiol. 2010 Jan; 55(1):99-107. 20122555

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
010181 Beta-2 Microglobulin, Serum 1952-1 010181 Beta-2 Microglobulin, Serum mg/L 1952-1

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