Glucocorticoid Receptors in Immunological Subtypes of Childhood Acute Lymphocytic Leukemia Cells: A Pediatric Oncology Group Study

Glucocorticoid receptors were quantitated by a whole cell method in cells from 593 children with acute leukemia at the time of diagnosis. Leukemia cells were also immunologically typed and divided into early pre-B- (not reactive with antibodies to T-lymphocyte antigens, surface immunoglobulin-negative, cytoplasmic immunoglobulin-negative), pre-B- (not reactive with antibodies to T-lymphocyte antigens, surface immunoglobulin-negative, cytoplasmic immunoglobulin-positive). B- (not reactive with antibodies to T-lymphocyte antigens, surface immunoglobulin-postive), and T- (reactive with antibodies to T-lymphocyte antigens) subtypes. There was a median of 9.7 x 10³ sites per cell in the 359 with early pre-B-acute lymphocytic leukemia, a median of 8.1 x 10³ sites per cell from 103 patients with pre-B-cell leukemia, and a median of 4.0 x 10³ sites per cell from 116 patients with T-cell leukemia. The distributions per cell were significantly different among these 3 groups (P < 0.0001). The 15 patients with B-cell disease had a median of 3.2 x 10³ sites per cell. At the time of analysis, remission induction data are available for most of these patients. Within the early pre-B-group 291 patients with a median receptor number of 9.9 x 10³ achieved remission, while 13 with a median receptor number of 4.8 x 10³did not. These distributions were significantly different (P = 0.034). Within the pre-B- and T-cell groups the distributions of receptor numbers for responders and non-responders were not significantly different. We conclude that each immunological subtype has characteristic receptor distribution. High receptor number within the null group is associated with the ability of the patient to achieve remission; however, the range of values within each patient group is too broad to use this assay as a predictor of response for any individual patient.