Clinical implications of glucocorticoid receptors in human leukemia

Normal lymphoid cells contain glucocorticoid receptor. A variety of stimuli that activate these cells also induce increases in receptor concentration. Similar glucocorticoid receptors can be detected in lymphoid cells from patients with acute lymphoblastic leukemia (ALL). Absence of the glucocorticoid receptor (usually found in treated patients) predicts lack of glucocorticoid responsiveness. Furthermore, in our hands, glucocorticoid receptor levels correlate with the duration of complete remission in ALL (though not in other forms of leukemia). This association is independent of cell type, age, sex, or initial leukocyte count. The level of receptor shows a negative correlation with increasing aggressiveness of the tumor (null-cell leukemia greater than T-cell leukemia greater than Burkitt's lymphoma).