[Expressions of P-gp, mdr1, MRP and Topo II in acute leukemia patients and their correlation with prognosis].
OBJECTIVE
To investigate whether P-gp, mdr1, MRP and Topo II are the prognostic factors of clinical resistance in acute leukemia (AL) patients.


METHODS
The expression of P-gp was analyzed by flow cytometry using monoclonal antibody UIC2, the expressions of mdr1, MRP and Topo II by RT-PCR in 45 AL samples.


RESULTS
The expressions of P-gp, mdr1 and MRP were significantly higher in resistant group than that in sensitive group (P < 0.01). The expression of Topo II was lower in resistant group, but the difference was not statistically significant. Logistic regression of univariate analysis showed that the overexpression of P-gp, mdr1 and MRP, the lower expression of Topo II and age over 55 were the prognostic factors of clinical resistance in AL. Sex, initial white blood cell count (WBC), bone marrow (BM) blast percentage and FAB subtypes were not significant for the clinical resistance. Multivariate analysis adjusted by above factors showed that the overexpression of P-gp, mdr1 and MRP, the low expression of Topo II and age over 55 were still highly significant for clinical resistance. It was also found that there were significant correlations between P-gp, mdr1, MRP and complete remission in 36 newly diagnosed AL. Significant correlations were observed between P-gp and mdr1, mdr1 and MRP, and P-gp and MRP expression in all AL cases and in clinical resistance group (P < 0.001).


CONCLUSIONS
The overexpression of P-gp, mdr1 and MRP, and the lower expression of Topo II are the unfavorable prognostic factors of clinical resistance in AL. There is correlation between mdr1 and MRP expressions.
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000235:genetics* / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D000368:Aged; D004250:DNA Topoisomerases, Type II / Q000235:genetics* / Q000378:metabolism; D019008:Drug Resistance, Neoplasm; D005260:Female; D015973:Gene Expression Regulation, Leukemic; D006801:Humans; D007938:Leukemia / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D027425:ATP-Binding Cassette, Sub-Family C Proteins / Q000235:genetics* / Q000378:metabolism; D011379:Prognosis; D055815:Young Adult
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D004250:DNA Topoisomerases, Type II; D027425:ATP-Binding Cassette, Sub-Family C Proteins