[Multi-drug resistance and myelodysplastic syndromes: a possible role for remission inducing agents?].
Expression of P-glycoprotein (PGP), the product of the multidrug resistance gene (mdr1), is common in myelodysplastic syndromes (MDSs) and explains in part the low rate of complete remissions (CRs) obtained after aggressive chemotherapy. Reversion of the mdr phenotype to restore chemosensitivity has been the focus of many studies over the last ten years. Two phase III studies evaluated quinine for obtaining reversion of mdr gene expression in MDSs treated by aggressive chemotherapy. Results suggested better response rates and longer survival times in quinine-treated MDR-positive patients. However, the toxicity of quinine warrants further work aimed at developing other mdr phenotype reversion-inducing agents. Some such agents have proved superior over quinine in in vitro studies. Reversion of other mechanisms underlying chemoresistance in MDSs is a promising avenue of research.
Wattel
E
E
Service des Maladies du Sang, Hôpital Huriez, CHU Lille, France.
Lepelley
P
P
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000494:pharmacology*; D018432:Drug Resistance, Multiple; D005260:Female; D019450:Genes, MDR / Q000235:genetics*; D006801:Humans; D008297:Male; D009190:Myelodysplastic Syndromes / Q000188:drug therapy* / Q000235:genetics; D012074:Remission Induction
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1