THE ROLE OF Β2-MICROGLOBULIN IN ASSESSING THE PROGRESSION OF B-CELL CHRONIC LYMPHOCYTIC LEUKEMIA

Introduction. The primary assessment of β2-microglobulin holds significant value in monitoring the dynamics of oncohematological processes, which can serve as a crucial marker for evaluating the baseline condition of patients with B-cell chronic lymphocytic leukemia. Aim: to analyze the levels of β2-microglobulin in patients experiencing progression of B-cell chronic lymphocytic leukemia. Materials and methods. Twenty six patients with progressive B-cell chronic lymphocytic leukemia (CLL) were examined, comprising 12 males (46%) and 14 females (54%). These patients were designated as Group I. The control group (Group II) included 20 healthy individuals aged 23–43 years, consisting of 11 females (55%) and 9 males (45%). In Group I, disease staging was assessed using the Rai-Binet classification: stage II (B) was observed in 18 patients (69.2%), stage III (C) in 4 patients (15.4%), and stage IV (C) in 4 patients (15.4%). Among patients with progressive CLL, hyperplastic syndrome was evaluated, including lymph node enlargement (≥3 cm in diameter) and hepato- or splenomegaly (liver or spleen extending ≥5 cm below the costal margin). General and biochemical blood analyses were conducted, along with measurements of β2-microglobulin levels. Statistical methods were applied to process and analyze the data. Results. In patients with progression of B-cell chronic lymphocytic leukemia (CLL), hematological analysis revealed anemia (hemoglobin <100 g/L) in 6 patients (23.1%) and thrombocytopenia in 8 patients (30.7%). Leukocytosis with leukocyte levels >100 G/L was observed in 4 patients (15.4%) in Group I. Notably, an inverse correlation was identified between β2-microglobulin levels and hemoglobin levels (r = -0.52; p = 0.02). Biochemical analysis showed a reduction in total serum protein to grade 1 according to CTCAE in 2 patients (7.7%), elevated serum creatinine levels, reaching grade 1 according to CTCAE, were observed in 4 patients (15.4%) in Group I. An inverse correlation was found between β2-microglobulin levels and total serum protein levels (r = -0.44; p = 0.02). A direct correlation was also identified between β2-microglobulin levels and serum creatinine levels (r = 0.65; p = 0.04). In 9 (34.7%) patients of group I, the concentration of β2-microglobulin in blood serum exceeded the level of 5 mg/l. It is important that all 100% (9/9) of patients in this category were found to have hyperplastic syndrome. In addition, 33.3% (3/9) of patients had a combination of lymphadenopathy, splenomegaly, and hepatomegaly (liver +5 cm below the edge of the costal arch), 55.6% (5/9) had a combination of two factors, in 11, 1% (1/9) hyperplastic syndrome was characterized by an increase in the size of peripheral lymph nodes by more than 3 cm. The average level of β2-microglobulin was 6.24 mg/l in patients with progression of B-cell chronic lymphocytic leukemia of group I, of which 9 patients had a level of β2-microglobulin greater than 5 mg/l. Conclusion. The level of β2-microglobulin corresponds to the severity of progression of B-cell chronic lymphocytic leukemia and correlates with the level of anemia, hypoproteinemia, hypercreatinemia, and the severity of hyperplastic syndrome.