Beta-2 microglobulin (B2m) is the 11.

8 kDa light-chain moiety of

major histocompatibility complex class I (MHC I) present on the
surface of nearly all nucleated cells
MHC I functions immunologically in antigen presentation to
cytotoxic T cells
MHC I complex has also been implicated in nonimmunologic
functions associated with hormone/growth factor (EGF, insulin,
IGF-I, IGF-II) receptor interactions and cellular proliferation
MHC I are present on almost all cells (a significant exception is red
blood cells)
circulating B2m
B2m is elevated in several lymphoproliferative disorders including
chronic lymphocytic leukemia, lymphomas, and multiple myeloma
prognostic power of B2m with regard to overall survival has also
been shown for B-cell malignancies such as diffuse large cell and
follicular lymphoma and , multiple myeloma, chronic lymphocytic
leukaemia and acute lymphoblastic leukaemia (1)
B2M level at the time of diagnosis to be an independent
prognostic parameter for survival and for the risk of developing
acute myeloid leukaemia in high-risk myelodysplastic syndrome
patients (2)
elevation in tissue/serum levels of B2m in solid malignancies such
as breast, lung, gastrointestinal, and nasopharyngeal carcinomas
has also been reported
B2m levels also rise during infection with some viruses, including
cytomegalovirus and human immunodeficiency virus (HIV).
Studies show that as HIV disease advances, beta2-microglobulin
levels increase
serum levels may also be increased due to increased production
in hepatitis, sarcoidosis, Crohn's disease and vasculitis
urinary levels are increased in tubular damage

possible causes of raised urinary levels include:

heavy-metal poisoning e.g. mercury, cadmium, cis-platinum
drug toxicity e.g. aminoglycosides, cyclosporin
hereditary e.g. Fanconi's syndrome, Wilson's disease, cystinosis
pyelonephritis
renal allograft rejection
others e.g. nephrocalcinosis
Notes:
if renal disease is suspected, comparing serum and urine B2m
levels helps identify the site of renal damage
B2m normally is filtered by the renal glomeruli, only to be partially
reabsorbed back into the blood when it reaches the renal tubules
in glomerular disease, the glomeruli cannot filter it out of the
blood, so serum levels increase and B2m levels decrease in the
urine
in tubular disease, the tubules cannot reabsorb it back into the
blood, so urine levels rise and serum levels fall
after a kidney transplant, increased serum levels may be an early
sign of rejection
Reference:
1) Gatto S et al. Contribution of beta-2 microglobulin levels to the
prognostic stratification of survival in patients with
myelodysplastic syndrome (MDS). Blood 2003;102:1622-1625.
2) Neumann F et al. Levels of beta 2 microglobulin have a
prognostic relevance for patients with myelodysplastic syndrome
with regard to survival and the risk of transformation into acute
myelogenous leukemia Leukemia Research 2009; 33(2): 232-236

3) Rowley RD et al. beta-2 Microglobulin is mitogenic to PC-3

prostatic carcinoma cells and antagonistic to transforming growth
factor beta 1 action. Cancer Res (1995);55:781-786.
4) Jacobs EL, Haskell CM. Clinical use of tumor markers in
oncology. Curr Prob Cancer 1991;15: 301-320.