title: P-Glycoprotein Expression in Acute Myeloid Leukaemia Cells at Diagnosis: Its relationship to Daunorubicin or Idarubicin Induction Therapy and Survival.
abstract: We investigated the expression of P-glycoprotein (P-gp) in 50 adults with de novo diagnosed acute myeloid leukaemia (AML) and the relationship between presence of P-gp in leukaemic cells and efficacy, as remission induction and survival rate, of two different anthracyclines, daunorubicin (DNR) and idarubicin (IDR). We found that 30 out of 50 patients (60%) were negative (Group 1) and 20 (40%) were positive (Group 2) for P-gp expression evaluated by mean of MRK16 MoAb using a cut-off of 10% positive cells. Thirty-five out of 50 patients (70%) obtained complete remission (CR); depending on P-gp expression, the CR rate was 80% for group 1 and 45% for group 2 (p lt; 0.005). The median duration of overall survival was 20 months for patients in Group 1 as compared with 10 months for patients of Group 2 (p < 0.005). Regarding the anthracycline used, no significant difference in CR was observed in patients of Group 1 (75% of CR with DNR vs. 90% with IDR); Group 2 obtained 40% of CR with DNR vs. 70% with IDR (p < 0.005). The median duration of overall survival (OS) with the two regimens was comparable in Group 1, while it was significantly longer in patients of Group 2 treated with IDR compared with DNR regimen (p < 0.005). These results confirm the prognostic value of P-gp expression in AML at first appearance and we suggest that idarubicin could be a valid anthracycline drug in the treatment of AML to be evaluated as potential drug of choice in patients with primary or drug-induced multidrug resistance.
authors.affiliation: a Department of Internal Medicine, Division of Haematology , University of Milan, S. Gerardo Hospital , Via Donizetti 106, 20052 Monza , Milan , Italy.
authors.forename: E M
authors.initials: EM
authors.lastname: Pogliani
authors.affiliation: a Department of Internal Medicine, Division of Haematology , University of Milan, S. Gerardo Hospital , Via Donizetti 106, 20052 Monza , Milan , Italy.
authors.forename: M
authors.initials: M
authors.lastname: Carpenedo
authors.affiliation: a Department of Internal Medicine, Division of Haematology , University of Milan, S. Gerardo Hospital , Via Donizetti 106, 20052 Monza , Milan , Italy.
authors.forename: I
authors.initials: I
authors.lastname: Miccolis
authors.affiliation: a Department of Internal Medicine, Division of Haematology , University of Milan, S. Gerardo Hospital , Via Donizetti 106, 20052 Monza , Milan , Italy.
authors.forename: D
authors.initials: D
authors.lastname: Belotti
authors.affiliation: a Department of Internal Medicine, Division of Haematology , University of Milan, S. Gerardo Hospital , Via Donizetti 106, 20052 Monza , Milan , Italy.
authors.forename: G M
authors.initials: GM
authors.lastname: Corneo
keywords: P-glycoprotein; acute myeloid leukaemia; daunorubicin; idarubicin