Glucocorticoid receptor levels predict response to treatment in human lymphoma.

Neoplastic tumor masses from 47 adults with B cell malignant lymphomas were examined for glucocorticoid receptors and in vitro sensitivity to glucocorticoids. The patients were then treated with dexamethasone as a single agent for 5-14 days. Forty-seven percent of patients achieved at least a partial remission; 40% had no significant tumor response. Lymphoma cells from patients who responded had significantly more glucocorticoid receptor sites per cell and greater in vitro sensitivity as measured by glucocorticoid inhibition of incorporation of thymidine than did tumor cells from non-responders. Using a receptor level of 3000 sites/cell, response could accurately be predicted in 82% of patients. Our data suggest that study of tumor glucocorticoid receptors and glucocorticoid sensitivity in vitro may allow selection of those patients with lymphoma who should receive glucocorticoids as part of combination chemotherapy.