title: Prognostic significance of glucocorticoid receptor determination in patients with chronic lymphocytic leukemia and immunocytoma--lack of a positive correlation between receptor levels and clinical responsiveness.
abstract: Glucocorticoid receptors (GR) have been suggested to have prognostic significance in patients with CLL treated with chemotherapy containing glucocorticoid. In this study, the GR levels in 65 patients with advanced CLL and immunocytoma (clinical stages III and IV according to Rai) were determined by means of a whole cell assay. The median GR-level was 1,920 bs/c with a range from 0 to 9591. The patients were subsequently treated according to a prospective, randomized trial with either a combination of chlorambucil and prednisolone, or with prednimustine. No significant difference in receptor levels was found between responders (median = 1940 bs/c; n = 47) and nonresponders (median = 1950 bs/c; n = 14). To assess the influence of receptor content on prognosis we have analyzed the relationship between GR content and survival time and duration of response. There was no significant difference in duration of response and in survival between those patients with high (greater than 1920 bs/c) and those with low GR levels (less than 1920 bs/c) (log-rank test). Our data suggest that determination of GR provides no reliable indicator for clinical response to regimens with glucocorticoid as a component in patients with CLL and immunocytoma.
authors.affiliation: Department of Internal Medicine V, University of Heidelberg, F.R.G.
authors.forename: C
authors.initials: C
authors.lastname: Weiss
authors.forename: A D
authors.initials: AD
authors.lastname: Ho
authors.forename: E
authors.initials: E
authors.lastname: Hiller
authors.forename: E
authors.initials: E
authors.lastname: Thiel
authors.forename: R
authors.initials: R
authors.lastname: Schlag
authors.forename: T
authors.initials: T
authors.lastname: Lipp
authors.forename: R
authors.initials: R
authors.lastname: Herrmann
authors.forename: E
authors.initials: E
authors.lastname: Musch
authors.forename: B
authors.initials: B
authors.lastname: Termander
authors.forename: W
authors.initials: W
authors.lastname: Hunstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002699:Chlorambucil / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy / Q000378:metabolism / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D011379:Prognosis; D011965:Receptors, Glucocorticoid / Q000032:analysis*; D015996:Survival Rate
chemical_list: D011965:Receptors, Glucocorticoid; D002699:Chlorambucil; D011239:Prednisolone