D:/Biomedica Vol.26, Jan. – Jun. 2010/Bio-4.Doc P. 1 – 4 (WC) BETA-2-MICROGLOBULIN AS A MARKER OF EXTENT OF DISEASE IN NON-HODGKIN LYMPHOMA NAGHMANA MAZHER, ZAFAR IQBAL, NAUMAAN ASLAM, SEEMA MAZHER Department of Pathology, Post Graduate Medical Institute, Lahore ABSTRACT Introduction: Lymphomas are the malignancies of lymphoreticular system. These malignant lymphocytes accumulate either by duplicating faster than normal or they can live longer than normal. Malignant lymphomas represent clonal malignancies in which the majority of the cells are frozen at a single stage of normal differentiation. Two broad types of lymphomas are named as Hodgkin disease and Non-Hodgkin lymphoma. Serum Beta 2 microblobulin (β2m) is commonly increased in patients with haemopoietic malignancies and have been shown to be of prognostic value in patients especially with Non-Hodgkin lymphoma (NHL). Materials and Methods: Serum β2m level was determined in already diagnosed (n=60) patients of NHL. They were divided into two groups, 30 patients with bone marrow infiltration (group B) and the remaining without infiltration (group C). The values were compared with 20 healthy age and sex matched contrtols (group A). The estimations were made prior to the institution of chemotherapy. Results: β2m level was significantly raised in NHL patients compared with controls. There was also a signi- ficant difference when the values were compared between the patients of NHL with and without bone marrow infiltration. The levels showed positive correlation with the extent of the disease. We conclude that the above mentioned non invasive parameter is a useful indicator of the extent of the disease. Key Words: Non-Hodgkin Lymphoma, mucosa associated lymphoid tissue, Beta 2 microglo- bulin, Enzyme Linked Immunosorbent Assay. INTRODUCTION Lymphomas are defined as malignancies of lympho- reticular system. 1,2 Malignant lymphomas represent clonal malignancies in which majority of the cells are frozen at a single stage of normal differenti- ation. 3 About 85% of lymphomas are of B-cell origin and 15% of T-cell origin. B-cell originate and mature (differentiate) in the bone marrow while T-cells also start in the bone marrow but they differentiate and mature in the thymus gland. In non-Hodgkin lym- phoma (NHL) primary manifestations of disease occur outside the bone marrow at the site of normal lymphocytes homing lymph nodes, spleen, MALT (mucosa associated lymphoid tissue) or anywhere. Lymphomas outside lymph node and spleen are re- ferred to as extranodal lymphomas. A patient with NHL may present with localized and generalised peripheral lymphadenopathy 6-9 . NHL constitutes an intimidating and extended fam- ily of lymphoid neoplasm encompassing diverse B- cell malignancies of lymph node follicle and several less common T-cell proliferations, plus a smattering of macrophage malignancies. Once histological dia- gnosis of malignant lymphoma has been estab- lished, it is mandatory to determine extent of dise- ase so that treatment protocol may be decided. 10 Patients at high risk for failure with conven- tional therapy may benefit from investigational approaches. The biological markers of NHL are dis- tinguished in three categories: serological, immuno- phenotypic and molecular markers. The clinical importance of biological markers in NHL is based on their support of morphological diagnosis, their role in staging and prognostic assessment. Among the most important serological markers Beta-2- microglobulin (β2m) reflects the tumour load. β2m is a low molecular weight polypeptide, non- covalently linked to the heavy chain of class 1- his- tocompatability antigens which are shed with cell turnover. It is plentiful on the surface of lympho- cytes. Increased production or destruction of the cells causes β2m levels in the blood to increase. 11,12 This study was conducted to assess the level of serum β2m in the patients of NHL with and without bone marrow infiltration. PATIENTS AND METHODS Biomedica Vol. 26 (Jan. - Jun. 2010)