Abstract
A retrospective study was undertaken to evaluate terminal transferase activity and glucocorticoid receptor content as predictors of prognosis in 52 adult patients with acute myeloid leukemia (AML). Eighteen patients who had detectable levels of TdT in their leukaemic cells (greater than or equal to 0.1 unit microgram-1 DNA), had a higher complete remission rate than patients with low TdT activity. Patients below 60 years with increased TdT activity also had longer survival as compared to those with low TdT levels. By combining cytochemical analysis of peroxidase and immunocytochemical staining for TdT it was possible to show that the enzyme was located in leukaemic cells of myeloid origin. Leukemias of monocytic origin had no detectable TdT activity in 10/11 cases. The cellular content of the cytoplasmic glucocorticoid receptor varied from 0 to 2.8 fmol micrograms-1 DNA. There was no difference in receptor content between the different FAB subgroups. High levels of the receptor (greater than or equal to 0.22 fmol microgram-1 DNA) were positively correlated with the remission rate. Patients with TdT levels of greater than or equal to 0.1 unit microgram-1 DNA and a glucocorticoid receptor concentration of greater than or equal to 0.22 fmol microgram-1 DNA had significantly higher remission (P = 0.001) and survival rates (P = 0.007) compared with those with undectectable levels of both TdT and low receptor content. It is thus concluded that combined measurements of TdT and the glucocorticoid receptor are useful predictors of prognosis in AML.
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Selected References
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- Bennett J. M., Catovsky D., Daniel M. T., Flandrin G., Galton D. A., Gralnick H. R., Sultan C. Proposals for the classification of the acute leukaemias. French-American-British (FAB) co-operative group. Br J Haematol. 1976 Aug;33(4):451–458. doi: 10.1111/j.1365-2141.1976.tb03563.x. [DOI] [PubMed] [Google Scholar]
- Hoffbrand A. V., Ganeshaguru K., Janossy G., Greaves M. F., Catovsky D., Woodruff R. K. Terminal deoxynucleotidyl-transferase levels and membrane phenotypes in diagnosis of acute leukaemia. Lancet. 1977 Sep 10;2(8037):520–523. doi: 10.1016/s0140-6736(77)90662-6. [DOI] [PubMed] [Google Scholar]
- Keating M. J., Smith T. L., Gehan E. A., McCredie K. B., Bodey G. P., Spitzer G., Hersh E., Gutterman J., Freireich E. J. Factors related to length of complete remission in adult acute leukemia. Cancer. 1980 Apr 15;45(8):2017–2029. doi: 10.1002/1097-0142(19800415)45:8<2017::aid-cncr2820450806>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]
- Knospe W. H., Conrad M. E. The danger of corticosteroids in acute granulocytic leukemia. Med Clin North Am. 1966 Nov;50(6):1653–1668. doi: 10.1016/s0025-7125(16)33111-x. [DOI] [PubMed] [Google Scholar]
- Lippman M. E., Yarbro G. K., Leventhal B. G. Clinical implications of glucocorticoid receptors in human leukemia. Cancer Res. 1978 Nov;38(11 Pt 2):4251–4256. [PubMed] [Google Scholar]
- Marcus S. L., Smith S. W., Jarowski C. I., Modak M. J. Terminal deoxyribonucleotidyl transferase activity in acute undifferentiated leukemia. Biochem Biophys Res Commun. 1976 May 3;70(1):37–44. doi: 10.1016/0006-291x(76)91105-0. [DOI] [PubMed] [Google Scholar]
- Marks S. M., Baltimore D., McCaffrey R. Terminal transferase as a predictor of initial responsiveness to vincristine and prednisone in blastic chronic myelogenous leukemia: a co-operative study. N Engl J Med. 1978 Apr 13;298(15):812–814. doi: 10.1056/NEJM197804132981503. [DOI] [PubMed] [Google Scholar]
- Ost A., Lagerlöf B., Sundström C., Lindström P., Gyllenhammer H., Engstedt L., Skoog L. A study of the reproducibility of the diagnostic criteria for acute leukaemia. Scand J Haematol. 1983 Sep;31(3):257–266. doi: 10.1111/j.1600-0609.1983.tb00650.x. [DOI] [PubMed] [Google Scholar]
- SHANBROM E., MILLER S. Critical evaluation of massive steroid therapy of acute leukemia. N Engl J Med. 1962 Jun 28;266:1354–1358. doi: 10.1056/NEJM196206282662603. [DOI] [PubMed] [Google Scholar]
- Sahai Srivastava B. I., Khan S. A., Henderson E. S. High terminal deoxynucleotidyl transferase activity in acute myelogenous leukemia. Cancer Res. 1976 Oct;36(10):3847–3850. [PubMed] [Google Scholar]
- Sasaki R., Takaku F., Aoki T., Bollum F. J., Saito T., Dan S. Terminal deoxynucleotidyl transferase activities and glucocorticoid receptors in leukaemia. Br J Cancer. 1981 Jul;44(1):63–67. doi: 10.1038/bjc.1981.148. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Skoog L., Nordenskjöld B., Ost A., Andersson B., Hast R., Giannoulis N., Humla S., Hägerström T., Reizenstein P. Glucocorticoid receptor concentrations and terminal transferase activity as indicators of prognosis in acute non-lymphocytic leukaemia. Br Med J (Clin Res Ed) 1981 Jun 6;282(6279):1826–1829. doi: 10.1136/bmj.282.6279.1826. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wrange O., Humla S., Ramberg I., Gustafsson S. A., Skoog L., Nordenskjöld B., Gustafsson J. A. Progestin-receptor analysis in human breast cancer cytosol by isoelectric focusing in slabs of polyacrylamide gel. J Steroid Biochem. 1981 Feb;14(2):141–148. doi: 10.1016/0022-4731(81)90166-7. [DOI] [PubMed] [Google Scholar]
