In leukocytes from peripheral blood of patients with acute lymphoblastic leukemia (ALL) we have measured glucocorticoid receptors (GRs) and glutamine synthetase activity. In addition, short-term response to steroid treatment and inducibility of complete remission were determined. Using both whole cell and cytosol binding assays with [3H]-triamcinolone acetonide, leukemic lymphoblasis from all the patients studied were found to contain specific high affinity GRs. However, the cytosol assay consistently underestimated the number of receptor sites with respect to the whole cell assay. There was a significant difference in the number of receptor sites, as measured by whole cell assay, between those patients who did and did not respond to treatment with glucocorticoids alone. Lymphoblasts from T- and B-cell leukemia contained fewer receptor sites than those from Null-cell leukemia. Density of receptor was closely correlated with the in vivo sensitivity to polychemotherapy. Density of receptor also correlated positively with the steroid-induced increase in glutamine synthetase activity. It is likely that the analysis of functional GR in ALL cells may be a useful adjunct to the already existing clinical and immunological prognostic indicators.
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