TY - JOUR
T1 - Hypoxanthine‐guanine phosphoribosyl‐transferase in childhood leukemia
T2 - Relation with immunophenotype, in vitro drug resistance and clinical prognosis
AU - Pieters, R.
AU - Huismans, D. R.
AU - Loonen, A. H.
AU - Peters, G. J.
AU - Hählen, K.
AU - van der Does‐van den Berg, A.
AU - van Wering, E. R.
AU - Veerman, A. J.P.
PY - 1992/5/8
Y1 - 1992/5/8
N2 - Decreased activity of hypoxanthine‐guanine phosphoribosyltransferase (HGPRT), responsible for the conversion of 6‐mercaptopurine and 6‐thioguanine (6‐TG) to their cytotoxic nucleotides, may cause resistance to these thiopurines in experimental leukemic systems. The clinical significance of this mechanism is as yet unclear. In 83 children with untreated acute lymphoblastic leukemia (ALL), we determined the prognostic value of HGPRT activity and the relation between HGPRT activity and resistance to thiopurines. HGPRT activity was determined radiochemically; in vitro resistance to 6‐TG with the MTT assay. HGPRT level was significantly lower in T‐ALL than in B‐lineage ALL; no differences were found between sequential differentiation stages of B‐lineage ALL. HGPRT activity was inversely related to the white‐blood‐cell count (WBC). Among patients with cALL and pre‐B‐ALL with WBC < 50 × 109/I, cases with a low HGPRT had a significantly poorer prognosis than those with a high HGPRT. WBC, age, sex, organomegaly and differentiation stage were comparable in both patient groups. No correlation was found between HGPRT activity and in vitro 6‐TG resistance in cALL and pre‐B‐ALL patients. T‐ALL cases were not more 6‐TG‐resistant than cALL and pre‐B‐ALL cases. Cells from 6 relapsed ALL cases did not show decreased HGPRT activity. We conclude that: (a) HGPRT is lower in T‐ than in B‐lineage ALL and is constant in sequential differentiation stages of B‐lineage ALL; (b) HGPRT activity is inversely related to tumor load; (c) low HGPRT activities are correlated with a poorer prognosis in precursor B‐ALL but this cannot be explained by thiopurine resistance because (d) there is no relation between HGPRT activity and in vitro 6‐TG resistance.
AB - Decreased activity of hypoxanthine‐guanine phosphoribosyltransferase (HGPRT), responsible for the conversion of 6‐mercaptopurine and 6‐thioguanine (6‐TG) to their cytotoxic nucleotides, may cause resistance to these thiopurines in experimental leukemic systems. The clinical significance of this mechanism is as yet unclear. In 83 children with untreated acute lymphoblastic leukemia (ALL), we determined the prognostic value of HGPRT activity and the relation between HGPRT activity and resistance to thiopurines. HGPRT activity was determined radiochemically; in vitro resistance to 6‐TG with the MTT assay. HGPRT level was significantly lower in T‐ALL than in B‐lineage ALL; no differences were found between sequential differentiation stages of B‐lineage ALL. HGPRT activity was inversely related to the white‐blood‐cell count (WBC). Among patients with cALL and pre‐B‐ALL with WBC < 50 × 109/I, cases with a low HGPRT had a significantly poorer prognosis than those with a high HGPRT. WBC, age, sex, organomegaly and differentiation stage were comparable in both patient groups. No correlation was found between HGPRT activity and in vitro 6‐TG resistance in cALL and pre‐B‐ALL patients. T‐ALL cases were not more 6‐TG‐resistant than cALL and pre‐B‐ALL cases. Cells from 6 relapsed ALL cases did not show decreased HGPRT activity. We conclude that: (a) HGPRT is lower in T‐ than in B‐lineage ALL and is constant in sequential differentiation stages of B‐lineage ALL; (b) HGPRT activity is inversely related to tumor load; (c) low HGPRT activities are correlated with a poorer prognosis in precursor B‐ALL but this cannot be explained by thiopurine resistance because (d) there is no relation between HGPRT activity and in vitro 6‐TG resistance.
UR - http://www.scopus.com/inward/record.url?scp=0026515099&partnerID=8YFLogxK
U2 - 10.1002/ijc.2910510208
DO - 10.1002/ijc.2910510208
M3 - Article
C2 - 1568789
AN - SCOPUS:0026515099
SN - 0020-7136
VL - 51
SP - 213
EP - 217
JO - International Journal of Cancer
JF - International Journal of Cancer
IS - 2
ER -