Glucocorticoid receptors in acute leukemia.

We evaluated the applicability of glucocorticoid receptor (GR) determinations to predict clinical responsiveness to polychemotherapy in acute leukemias by measuring GR in leukemic cells from 20 patients as well as in lymphocytes from 20 normal volunteers. The whole-cell binding assay with [3H]-dexamethasone was used. The GR level (mean +/- SD) was 4583 +/- 1384 sites/cell (range: 2050-8140) for normal lymphocytes. A significant amount of GR (5300 to 17,000 sites/cell) was detected in the blasts from 9/12 patients with acute lymphoblastic leukemia (ALL). The concentration of GR sites in ALL cells greatly exceeded that found in normal mononuclear cells (P less than 0.01). The absence of GR in ALL patients correlated with poor response to polychemotherapy including glucocorticoids. High receptor levels were associated with complete remission (P less than 0.005). The GR concentration (7288 +/- 2345 sites/cell) found in acute non-lymphoblastic leukemias (ANLL) was in the same range as that found in ALL cases. All ANLL patients had a substantial number of GR, significantly higher than the sites/cell found in normal lymphocytes (P less than 0.05). No correlation between clinical responsiveness and receptor level was demonstrable for ANLL patients.