Weiss C, Ho A D, Hiller E, Thiel E, Schlag R, Lipp T, Herrmann R, Musch E, Termander B, Hunstein W
Department of Internal Medicine V, University of Heidelberg, F.R.G.
Leuk Res. 1990;14(4):327-32. doi: 10.1016/0145-2126(90)90159-7.
Glucocorticoid receptors (GR) have been suggested to have prognostic significance in patients with CLL treated with chemotherapy containing glucocorticoid. In this study, the GR levels in 65 patients with advanced CLL and immunocytoma (clinical stages III and IV according to Rai) were determined by means of a whole cell assay. The median GR-level was 1,920 bs/c with a range from 0 to 9591. The patients were subsequently treated according to a prospective, randomized trial with either a combination of chlorambucil and prednisolone, or with prednimustine. No significant difference in receptor levels was found between responders (median = 1940 bs/c; n = 47) and nonresponders (median = 1950 bs/c; n = 14). To assess the influence of receptor content on prognosis we have analyzed the relationship between GR content and survival time and duration of response. There was no significant difference in duration of response and in survival between those patients with high (greater than 1920 bs/c) and those with low GR levels (less than 1920 bs/c) (log-rank test). Our data suggest that determination of GR provides no reliable indicator for clinical response to regimens with glucocorticoid as a component in patients with CLL and immunocytoma.
糖皮质激素受体（GR）被认为在接受含糖皮质激素化疗的慢性淋巴细胞白血病（CLL）患者中具有预后意义。在本研究中，采用全细胞分析法测定了65例晚期CLL和免疫细胞瘤患者（根据Rai分期为III期和IV期）的GR水平。GR水平中位数为1920 bs/c，范围为0至9591。随后，这些患者根据一项前瞻性随机试验进行治疗，分别接受苯丁酸氮芥和泼尼松龙联合治疗或泼尼松氮芥治疗。在缓解者（中位数 = 1940 bs/c；n = 47）和未缓解者（中位数 = 1950 bs/c；n = 14）之间未发现受体水平有显著差异。为了评估受体含量对预后的影响，我们分析了GR含量与生存时间及缓解持续时间之间的关系。高GR水平（大于1920 bs/c）和低GR水平（小于1920 bs/c）的患者在缓解持续时间和生存方面均无显著差异（对数秩检验）。我们的数据表明，对于CLL和免疫细胞瘤患者，GR的测定并不能为含糖皮质激素方案的临床反应提供可靠指标。
