1.Significance of HALP Score as a Prognostic Indicator for Newly Diagnosed Multiple Myeloma.
Kuan-Shun ZHANG ; Dian-Liang LYU ; Lin SHI
Journal of Experimental Hematology 2025;33(2):442-446
OBJECTIVE:
To investigate the significance of HALP score as a prognostic indicator for newly diagnosed multiple myeloma (MM).
METHODS:
Clinical data of 62 newly diagnosed MM patients in our hospital from January 2020 to December 2022 were collected and retrospectively analyzed. The difference in age, sex, DS stage, R-ISS stage, M protein type, serum creatinine (Scr), β2-microglobulin (β2-MG), blood calcium, lactate dehydrogenase (LDH), hemoglobin (Hb), albumin (ALB), platelet count (PLT), and absolute lymphocyte count (ALC) between patients with low and high HALP scores were analyzed. The prognostic value of the above indexes in newly diagnosed MM patients was analyzed by univariate and multivariate analysis.
RESULTS:
The optimal cut-off value of HALP score was 41 determined by X-tile software. Based on this, 62 patients were divided into a high HALP group (HALP>41, n=25) and a low HALP group (HALP≤41, n=37). The proportion of patients with Hb≥100 g/L in the high HALP group was significantly higher than that in the low HALP group (P <0.05). The median overall survival (OS) time of patients in the high HALP group and low HALP group were 29 (9-39) months and 20 (4-29) months, respectively, with statistically significant difference between the two groups (P <0.01). Univariate analysis showed that R-ISS stage, ALB, Hb, ALC and HALP were closely related to the prognosis of patients (P <0.05). COX regression multivariate analysis showed that R-ISS stage Ⅲ (HR=4.443, 95%CI : 1.480-13.343,P =0.008) and HALP≤41(HR=8.823, 95%CI : 1.858-41.910,P =0.006) were independent risk factors for shortened OS in newly diagnosed MM patients. The median OS of patients with high HALP at R-ISS stage Ⅲ was significantly higher than that of patients with low HALP at the same stage, and the difference was statistically significant (P <0.05).
CONCLUSION
HALP score can be used as a prognostic indicator for newly diagnosed MM patients.
Humans
;
Multiple Myeloma/diagnosis*
;
Prognosis
;
Retrospective Studies
;
Male
;
Female
;
Middle Aged
;
Aged
;
beta 2-Microglobulin
;
Lymphocyte Count
2.Significance of Serum β2-Microglobulin for Survival and Relapse of Patients with Diffuse Large B-Cell Lymphoma in the Rituximab Era.
Yu-Ze YANG ; Ya-Ru XU ; Mei ZHOU ; Wen-Yan XU ; Li-Qiang ZHOU ; Zhen-Xing GUO
Journal of Experimental Hematology 2025;33(4):1057-1062
OBJECTIVE:
To investigate the significance of serum β2-microglobulin (β2-MG) for survival and relapse of patients with diffuse large B-cell lymphoma (DLBCL) in the rituximab era.
METHODS:
Clinical data of 92 patients with DLBCL admitted from December 2003 to July 2015 were retrospectively analyzed. The optimal cutoff value of β2-MG levels for predicting prognosis of the DLBCL patients was determined using receiver operating characteristic (ROC) curve. KaplanMeier analysis was used to estimate progression-free survival (PFS) and overall survival (OS). Cox logistic regression analysis was used to explore potential prognostic factors associated with survival. Binary logistic regression analysis was used to analyze the relationship between various factors and relapse.
RESULTS:
The most discriminative cutoff value for β2-MG level was determined to be 2.25 mg/L by the ROC curve. Subgroup analysis showed that patients in the elevated β2-MG (>2.25 mg/L) group had significantly worse PFS(P =0.006) and a trend toward worse OS compared with those in the low β2-MG (≤2.25 mg/L) group(P =0.053). Univariate analysis showed that elevated β2-MG, age>60 years, Ann Arbor stage III-IV, as well as IPI score ≥3 were associated with worse PFS. Binary logistic regression analysis showed that age>60 years and β2-MG>2.25 mg/L were potential influencing factors for relapse of DLBCL patients.
CONCLUSION
Serum β 2-MG might be an important predictor for the survival and relapse of DLBCL patients in the rituximab era.
Humans
;
Lymphoma, Large B-Cell, Diffuse/drug therapy*
;
beta 2-Microglobulin/blood*
;
Rituximab
;
Retrospective Studies
;
Prognosis
;
Female
;
Male
;
Middle Aged
;
Recurrence
;
ROC Curve
3.Proteomics reveals biomarkers for sepsis-associated acute kidney injury: a prospective multicenter cohort study.
Weimin ZHU ; Nanjin CHEN ; Hanzhi DAI ; Cuicui DONG ; Yubin XU ; Qi CHEN ; Fangyu YU ; Cheng ZHENG ; Chao ZHANG ; Sheng ZHANG ; Yinghe XU ; Yongpo JIANG
Chinese Critical Care Medicine 2025;37(8):707-714
OBJECTIVE:
To identify and validate novel biomarkers for the early diagnosis of sepsis-associated acute kidney injury (SA-AKI) and precise continuous renal replacement therapy (CRRT) using proteomics.
METHODS:
A prospective multicenter cohort study was conducted. Patients with sepsis admitted to five hospitals in Taizhou City of Zhejiang Province from April 2019 to December 2021 were continuously enrolled, based on the occurrence of acute kidney injury (AKI). Sepsis patients were divided into SA-AKI group and non-SA-AKI group, and healthy individuals who underwent physical examinations during the same period were used as control (NC group). Peripheral blood samples from participants were collected for protein mass spectrometry analysis. Differentially expressed proteins were identified, and functional enrichment analysis was conducted on these proteins. The levels of target proteins were detected by enzyme linked immunosorbent assay (ELISA), and the predictive value of target protein for SA-AKI were evaluated by receiver operator characteristic curve (ROC curve). Additionally, sepsis patients and healthy individuals were selected from one hospital to externally verify the expression level of the target protein and its predictive value for SA-AKI, as well as the accuracy of CRRT treatment.
RESULTS:
A total of 37 patients with sepsis (including 19 with AKI and 18 without AKI) and 31 healthy individuals were enrolled for proteomic analysis. Seven proteins were identified with significantly differential expression between the SA-AKI group and non-SA-AKI group: namely cystatin C (CST3), β 2-microglobulin (β 2M), insulin-like growth factor-binding protein 4 (IGFBP4), complement factor I (CFI), complement factor D (CFD), CD59, and glycoprotein prostaglandin D2 synthase (PTGDS). Functional enrichment analysis revealed that these proteins were involved in immune response, complement activation, coagulation cascade, and neutrophil degranulation. ELISA results demonstrated specific expression of each target protein in the SA-AKI group. Additionally, 65 patients with sepsis (38 with AKI and 27 without AKI) and 20 healthy individuals were selected for external validation of the 7 target proteins. ELISA results showed that there were statistically significant differences in the expression levels of CST3, β 2M, IGFBP4, CFD, and CD59 between the SA-AKI group and non-SA-AKI group. ROC curve analysis indicated that the area under the curve (AUC) values of CST3, β 2M, IGFBP4, CFD, and CD59 for predicting SA-AKI were 0.788, 0.723, 0.723, 0.795, and 0.836, respectively, all exceeding 0.7. Further analysis of patients who underwent CRRT or not revealed that IGFBP4 had a good predictive value, with an AUC of 0.84.
CONCLUSIONS
Based on proteomic analysis, CST3, β 2M, IGFBP4, CFD, and CD59 may serve as potential biomarkers for the diagnosis of SA-AKI, among which IGFBP4 might be a potential biomarker for predicting the need for CRRT in SA-AKI patients. However, further clinical validation is required.
Humans
;
Sepsis/complications*
;
Acute Kidney Injury/blood*
;
Proteomics
;
Prospective Studies
;
Biomarkers/blood*
;
Male
;
Female
;
beta 2-Microglobulin/blood*
;
Middle Aged
;
Cystatin C/blood*
;
Aged
4.Cerebrospinal Fluid β2-Microglobulin for Prognostic Evaluation of Patients with Central Nervous System Infiltration in Acute Lymphoblastic Leukemia.
Meng-Li YAO ; Ting-Mei CHEN ; Pu LI
Journal of Experimental Hematology 2022;30(1):113-118
OBJECTIVE:
To investigate the prognostic value of serum and cerebrospinal fluid β2-microglobulin (β2-MG) in acute lymphoblastic leukemia (ALL) with central nervous system invasion after chemotherapy.
METHODS:
40 patients with leukemia who had been confirmed to have central nervous system infiltration were selected for treatment at the Second Affiliated Hospital of Chongqing Medical University from January 2015 to May 2017, and the serum levels of β2-MG and CSF-β2MG were dynamically monitored and performed statistical analysis.
RESULTS:
After chemotherapy, the changes in serum β2-MG were not statistically significant (P>0.05); the absolute level of CSF-β2MG and the percentage of relative baseline changes were statistically different in different clinical outcome groups(P<0.05), and the decreasing CSF-β2MG levels suggest a better prognosis, with cut-off values of 1.505 and -25%, respectively.
CONCLUSION
The best cut-off point may be a predictor of complete remission; the reduction of the absolute and relative levels of CSF-β2MG can suggest a good prognosis for patients.
Central Nervous System
;
Cerebrospinal Fluid
;
Humans
;
Precursor Cell Lymphoblastic Leukemia-Lymphoma
;
Prognosis
;
Remission Induction
;
beta 2-Microglobulin
5.Construction of β2m knockout mice.
Zhen LI ; Ruilin SUN ; Wen LIU
Chinese Journal of Biotechnology 2021;37(8):2924-2935
The β2m (Beta-2-microglobin) gene encodes a non-glycosylated protein that functions as an important component of major histocompatibility complexⅠ(MHCⅠ) for antigen presentation. To evade immune mediated clearance, human tumors and pathogens have adopted different strategies, including loss of MHCⅠexpression. Appropriate animal models are essential for understanding the mechanisms underpinning the clinical treatment of tumor and other human diseases. We constructed β2m knockout mice using CRISPR/Cas9 gene editing tool through embryo microinjection. Subsequently, genotyping and phenotyping of knockout mice were performed by PCR, qPCR, and flow cytometry. Mice genotyping showed that the coding region of the target gene was absent in the knockout mice. Real time PCR showed that mRNA level of β2m was significantly downregulated. Flow cytometry showed that the proportions of CD8+ killer T cells was significantly reduced in a variety of tissues and organs of the immune system. Taken together, we have successfully constructed a strain of β2m knockout mice, which will facilitate subsequent in vivo study on the function and mechanism of the β2m gene.
Animals
;
Histocompatibility Antigens Class I
;
Mice
;
Mice, Inbred C57BL
;
Mice, Knockout
;
T-Lymphocytes, Cytotoxic
;
beta 2-Microglobulin/genetics*
6.Expression and Clinical Significance of Heat Shock Protein 90 in Multiple Myeloma Patients.
Shun-Quan WU ; Hui-Jun CHEN ; Rong ZHAN
Journal of Experimental Hematology 2021;29(2):525-529
OBJECTIVE:
To investigate the expression of HSP90 in bone marrow samples of multiple myeloma (MM) patients and explore its clinical significance.
METHODS:
Maxvision immunohistochemistry technique was used to detect the protein expression level of HSP90 76 MM patients and 29 normal healthy donors. The clinical characteristics of the patients were collected, and the correlation between the HSP90 expression and the clinical characteristics was analyzed.
RESULTS:
The count of MM patients with positive HSP90 protein was significantly higher than that of normal healthy donor, and there were no significant correlation between HSP90 expression and age, sex, hemoglobin (Hb), creatinine (CREA), blood calcium, lactate dehydrogenase (LDH), bone marrow plasma cell proportion and MM subtypes (P>0.05), but HSP90 expression was correlated with β
CONCLUSION
HSP90 protein was over-expressed in MM patients, and was correlated with β
Bone Marrow
;
HSP90 Heat-Shock Proteins
;
Humans
;
Multiple Myeloma
;
Prognosis
;
beta 2-Microglobulin
7.Predictive Value of Serum Creatinine, Blood Urea Nitrogen, Uric Acid, and β-Microglobulin in the Evaluation of Acute Kidney Injury after Orthotopic Liver Transplantation.
Hai-Yang LU ; Xin-Yu NING ; Ying-Qi CHEN ; Shu-Jun HAN ; Ping CHI ; Sai-Nan ZHU ; Yun YUE
Chinese Medical Journal 2018;131(9):1059-1066
BackgroundAs a major complication after orthotopic liver transplantation (OLT), the occurrence of acute kidney injury (AKI) is frequently defined by serum creatinine (Cr); however, the accuracy of commonly used blood urea nitrogen (BUN), uric acid (UA), and β-microglobulin (β-MG) remains to be explored. This retrospective study compared the accuracy of these parameters for post-OLT AKI evaluation.
MethodsPatients who underwent OLT in three centers between July 2003 and December 2013 were enrolled. The postoperative AKI group was diagnosed by the Kidney Disease Improving Global Outcomes (KDIGO) criteria and classified by stage. Measurement data were analyzed using the t-test or Wilcoxon rank-sum test; enumerated data were analyzed using the Chi-square test or Fisher's exact test. Diagnostic reliability and predictive accuracy were evaluated using receiver operating characteristic (ROC) curve analysis.
ResultsThis study excluded 976 cases and analyzed 697 patients (578 men and 119 women); the post-OLT AKI incidence was 0.409. Compared with the no-AKI group, the AKI group showed very significant differences in Model for End-stage Liver Disease score (14.74 ± 9.91 vs. 11.07 ± 9.54, Z = 5.404; P < 0.001), hepatic encephalopathy (45 [15.8%] vs. 30 [7.3%], χ = 12.699; P < 0.001), hemofiltration (28 [9.8%] vs. 0 [0.0%], χ = 42.171; P < 0.001), and 28-day mortality (23 [8.1%] vs. 9 [2.2%], χ = 13.323; P <0.001). Moreover, mean values of Cr, BUN, UA, and β-MG in the AKI group differed significantly at postoperative days 1, 3, and 7 (all P < 0.001). ROC curve area was 0.847 of Cr for the detection of AKI Stage 1 (sensitivity 80.1%, specificity 75.7%, cutoff value 88.23 μmol/L), 0.916 for Stage 2 (sensitivity 87.6%, specificity 82.6%, cutoff value 99.9 μmol/L), and 0.972 for Stage 3 (sensitivity 94.1%, specificity 88.2%, cutoff value 122.90 μmol/L).
ConclusionThe sensitivity and specificity of serum Cr might be a high-value indicator for the diagnosis and grading of post-OLT AKI.
Acute Kidney Injury ; blood ; Adult ; Blood Urea Nitrogen ; Creatinine ; blood ; Female ; Humans ; Liver Transplantation ; Male ; Middle Aged ; Retrospective Studies ; Uric Acid ; blood ; beta 2-Microglobulin ; blood
8.Clinicopathological Characteristics of Hyperdiploidy with High-Risk Cytogenetics in Multiple Myeloma.
Naery YANG ; Yeung Chul MUN ; Chu Myong SEONG ; Hee Jin HUH ; Jungwon HUH
Annals of Laboratory Medicine 2018;38(2):160-164
In multiple myeloma (MM), hyperdiploidy (HD) is known to impart longer overall survival. However, it is unclear whether coexistent HD ameliorates the adverse effects of known high-risk cytogenetics in MM patients. To address this issue, we investigated the clinicopathological characteristics of HD with high-risk cytogenetics in MM. Ninety-seven patients with MM were included in the study. For metaphase cytogenetics (MC), unstimulated cells from bone marrow aspirates were cultured for either 24 or 48 hours. To detect HD by interphase fluorescence in situ hybridization (iFISH), we assessed trisomies of chromosomes 5, 7, 9, 11, 15, and 17. Of the 97 MM patients, 40 showed HD. The frequency of co-occurrence of HD and high-risk cytogenetics was 14% (14/97). When the clinicopathological characteristics were compared between the two groups of HD with high-risk cytogenetics vs. non-HD (NHD) with high-risk cytogenetics, the level of beta 2 microglobulin and stage distribution significantly differed (P=0.020, P=0.032, respectively). This study shows that some of the clinicopathological characteristics of MM patients with high-risk cytogenetics differ according to HD or NHD status.
beta 2-Microglobulin
;
Bone Marrow
;
Cytogenetics*
;
Fluorescence
;
Humans
;
In Situ Hybridization
;
Interphase
;
Metaphase
;
Multiple Myeloma*
;
Trisomy
9.The Implication and Significance of Beta 2 Microglobulin: A Conservative Multifunctional Regulator.
Ling LI ; Mei DONG ; Xiao-Guang WANG
Chinese Medical Journal 2016;129(4):448-455
OBJECTIVEThis review focuses on the current knowledge on the implication and significance of beta 2 microglobulin (β2M), a conservative immune molecule in vertebrate.
DATA SOURCESThe data used in this review were obtained from PubMed up to October 2015. Terms of β2M, immune response, and infection were used in the search.
STUDY SELECTIONSArticles related to β2M were retrieved and reviewed. Articles focusing on the characteristic and function of β2M were selected. The exclusion criteria of articles were that the studies on β2M-related molecules.
RESULTSβ2M is critical for the immune surveillance and modulation in vertebrate animals. The dysregulation of β2M is associated with multiple diseases, including endogenous and infectious diseases. β2M could directly participate in the development of cancer cells, and the level of β2M is deemed as a prognostic marker for several malignancies. It also involves in forming major histocompatibility complex (MHC class I or MHC I) or like heterodimers, covering from antigen presentation to immune homeostasis.
CONCLUSIONSBased on the characteristic of β2M, it or its signaling pathway has been targeted as biomedical or therapeutic tools. Moreover, β2M is highly conserved among different species, and overall structures are virtually identical, implying the versatility of β2M on applications.
Antigens, CD1 ; physiology ; Hemochromatosis Protein ; analysis ; Histocompatibility Antigens Class I ; physiology ; Humans ; Receptors, Fc ; physiology ; beta 2-Microglobulin ; blood ; chemistry ; deficiency ; physiology
10.Values of Detecting the Levels of β2-MG, TNF-α, CRP, IL-6 in the Patients with Multiple Myeloma.
Li-Juan DUAN ; Chao LI ; Ru-Yu YANG
Journal of Experimental Hematology 2015;23(5):1362-1365
OBJECTIVETo explore the values of detecting the serum levels of β2-MG, TNF-α, CRP, IL-6 in the patients with multiple myeloma.
METHODSA total of 40 patents with multiple myeloma were included in the experiment group, and 40 healthy volunteers were selected as the control group. The levels of β2-MG, TNF-α, CRP and IL-6 were detected and compared in 2 groups, the different durie-salmon (DS) stages of β2-MG, TNF-α, CRP and IL-6 in the experiment group were analyzed.
RESULTSThe levels of β2-MG, CRP, IL-6 in the experiment group were higher than those in control group (P < 0.05); the level of TNF-α in the experiment group was lower than that in control group (P < 0.05); the levels of β2-MG, CRP, IL-6 at stage I, II, III in the experiment group was higher than those in control group (P < 0.05); the level of TNF-α at stage I, II, III in the experiment group was lower than that in the control group (P < 0.05); the levels of β2-MG, CRP, IL-6 at stage I, II, III in the experiment group displayed an increasing tendency, the levels of TNF-α at stage I, II, III in the experiment group displayed a declining trend (P < 0.05); the levels of β2-MG, CRP, IL-6 in the experiment group after treatment for 8, 16 weeks were higher than those in control group (P < 0.05); the level of TNF-α in the experiment group after treatment for 8, 16 weeks was lower than that in control group (P < 0.05); the levels of β2-MG, CRP and IL-6 in the experiment group after treatment for 16 weeks were lower than those for 8 weeks (P < 0.05); the levels of TNF-α in the experiment group after treatment for 16 weeks were higher than those for 8 weeks (P < 0.05). The levels of APE1 after treatment in the experiment group were lower than that before treatment.
CONCLUSIONThe serum levels of β2-MG, TNF-α, CRP and IL-6 can be as index for diagnosis of multiple myeloma, can effectively evaluate the disease severity; their combination with APE1 expression level can evaluate the therapeutic efficacy; thus the detection of above-mentioned indexes is possessed of higher value for clinical applications.
C-Reactive Protein ; metabolism ; Case-Control Studies ; Humans ; Interleukin-6 ; blood ; Multiple Myeloma ; blood ; diagnosis ; Tumor Necrosis Factor-alpha ; blood ; beta 2-Microglobulin ; blood

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