Question:medium
Poor prognostic marker in Multiple Myeloma (MM) is:
Poor prognostic marker in Multiple Myeloma (MM) is:
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Recall which low molecular weight protein used in the International Staging System reflects tumour burden in Multiple Myeloma.
Updated On: Jun 23, 2026
- S. creatinine
- Hypercalcemia
- B2 microglobulins
- Telomerase
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The Correct Option is C
Solution and Explanation
Multiple Myeloma (MM) prognosis is best assessed by the ISS (International Staging System), which relies on two key parameters: serum Beta-2 microglobulin (B2M) and serum albumin.
Why B2M is the most important poor prognostic marker:
- B2M is the light chain of the MHC class I complex found on the surface of all nucleated cells
- In MM, rapidly proliferating plasma cells shed large amounts of B2M into serum
- Higher B2M = greater tumour burden = worse prognosis
ISS staging using B2M:
- Stage I: $B2M < 3.5$ mg/L and albumin $\geq 3.5$ g/dL (best prognosis)
- Stage II: Neither Stage I nor III criteria
- Stage III: $B2M \geq 5.5$ mg/L (worst prognosis)
Other CRAB features (Hypercalcemia, Renal failure, Anemia, Bone lesions) indicate disease activity but B2M is the validated staging and prognostic biomarker.
\[\boxed{\text{B2 microglobulins}}\]
Why B2M is the most important poor prognostic marker:
- B2M is the light chain of the MHC class I complex found on the surface of all nucleated cells
- In MM, rapidly proliferating plasma cells shed large amounts of B2M into serum
- Higher B2M = greater tumour burden = worse prognosis
ISS staging using B2M:
- Stage I: $B2M < 3.5$ mg/L and albumin $\geq 3.5$ g/dL (best prognosis)
- Stage II: Neither Stage I nor III criteria
- Stage III: $B2M \geq 5.5$ mg/L (worst prognosis)
Other CRAB features (Hypercalcemia, Renal failure, Anemia, Bone lesions) indicate disease activity but B2M is the validated staging and prognostic biomarker.
\[\boxed{\text{B2 microglobulins}}\]
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