Pui C H, Costlow M E
Leuk Res. 1986;10(2):227-9. doi: 10.1016/0145-2126(86)90046-9.
For 80 children with relapsed acute lymphoblastic leukemia, glucocorticoid receptor (GR) levels were lower in blast cells from patients who developed relapse while receiving chemotherapy (p = 0.03) and in those who failed reinduction treatment (p = 0.07). Serial determinations of GR at diagnosis and at relapse in blast cells from 41 patients disclosed various changes in receptor content, which were not related to the initial GR levels, the immunophenotype of blast cells or number of relapses. Six of 9 patients for whom reinduction therapy failed and only 7 of 32 patients in whom subsequent remission was induced had decreased GR levels at relapse (p = 0.018). One patient failed reinduction despite a sharp increase in GR level. Although a decrease in GR levels between diagnosis and relapse is associated with steroid resistance, other mechanism(s) can also be responsible for the development of steroid resistance in childhood leukemia.
对于80例复发的急性淋巴细胞白血病患儿，在接受化疗期间复发患者的原始细胞中糖皮质激素受体（GR）水平较低（p = 0.03），在再诱导治疗失败的患者中也是如此（p = 0.07）。对41例患者诊断时和复发时原始细胞中的GR进行系列测定，发现受体含量有各种变化，这些变化与初始GR水平、原始细胞的免疫表型或复发次数无关。再诱导治疗失败的9例患者中有6例，而随后诱导缓解的32例患者中只有7例在复发时GR水平降低（p = 0.018）。1例患者尽管GR水平急剧升高，但再诱导治疗仍失败。虽然诊断和复发之间GR水平的降低与类固醇耐药有关，但其他机制也可能导致儿童白血病中类固醇耐药的发生。
