Glucocorticoid receptor concentrations and terminal transferase activity as indicators of prognosis in acute non-lymphocytic leukaemia

Activity of terminal deoxynucleotidyl transferase (TdT), adenosine deaminase, and 5'nucleotidase and the cellular concentration of glucocorticoid (dexamethasone) receptor were determined in 25 patients with acute non-lymphocytic leukaemia. All patients were treated according to a common protoco...

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Bibliographic Details
Published in:BMJ 1981-06, Vol.282 (6279), p.1826-1829
Main Authors: Skoog, L, Nordenskjöld, B, Ost, A, Andersson, B, Hast, R, Giannoulis, N, Humla, S, Hägerström, T, Reizenstein, P
Format: Article
Language:English
Subjects:
5'-Nucleotidase
Acute lymphocytic leukemia
Adenosine Deaminase - blood
Adult
Aged
Blasts
Children
Clinical Research
Dexamethasone - metabolism
DNA Nucleotidyltransferases - blood
Enzymes
Female
Glucocorticoid receptors
Glucocorticoids
Humans
Leukemia
Leukemia - blood
Leukemia - mortality
Lymphocytes
Lymphocytes - metabolism
Male
Middle Aged
Nucleoside Deaminases - blood
Nucleotidases - blood
Prognosis
Receptors
Receptors, Glucocorticoid - metabolism
Receptors, Steroid - metabolism
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Summary:Activity of terminal deoxynucleotidyl transferase (TdT), adenosine deaminase, and 5'nucleotidase and the cellular concentration of glucocorticoid (dexamethasone) receptor were determined in 25 patients with acute non-lymphocytic leukaemia. All patients were treated according to a common protocol. Increased activity of TdT (greater than 0.1 unit/microgram DNA) was found in 11 patients. This group of patients was shown to have higher remission and survival rates (p = 0.06) compared with patients with low activity of TdT. The glucocorticoid receptor concentration of the leukaemic blast cells ranged from 0 to 0.94 fmol/microgram DNA. Thirteen patients had blast cells with a glucocorticoid receptor concentration over 0.22 fmol/microgram DNA. These patients had significantly increased remission and survival rates (p = 0.006) compared with those with a low receptor concentration. This finding cannot be explained by a difference in sensitivity to glucocorticoids since these were not used as therapeutic agents. Adenosine deaminase and 5'nucleotidase activities both varied within two orders of magnitude. No correlation could be found between activities of these enzymes and remission or survival rate. These results show that measurements of TdT activity and the glucocorticoid receptor concentration yield valuable prognostic information in acute non-lymphocytic leukaemia.
ISSN:0267-0623
0959-8138
1468-5833
DOI:10.1136/bmj.282.6279.1826