OBJECTIVE: To study the prognostic value of cd34, P-gp and Bcl-2 expression and MDR functional assays together with patients’ characteristics in patients with de novo acute leukemia.

METHODS: The expression levels of P-gp, CD34, Bcl-2 and the mean fluorescence intensity ratio of rhodamine 123 efflux assay (MIR (RE)) and intracellular daunorubicin accumulation assay (MIR (IDA)) of patients’ leukemia blast samples were prospectively determined with flow cytometry. The results of remission (CR) and non-remission (NR) patients were compared. Patients were given standard chemotherapy for remission induction.

RESULTS: CR patients were comparable to NR patients in age (39.2±23.0: 44.4±22.8, p=0.568, n=30). But NR patients had significantly higher peripheral white blood cell count than CR patients (72.84±78.74: 21.38±17.08, p=0.022, n=30). On the other hand, leukemia blasts samples of CR patients tend to express lower levels of CD34 (22.35±29.20: 46.18±39.5, p=0.084, n=30), P-gp (2.23±2.06: 11.95±22.90, p=0.111, n=30) and Bcl-2 (46.90±35.11: 57.02±31.97, p=0.434, n=30), but not significantly. However, the MIR (RE) (1.16±0.38 vs. 1.43±0.26, P=0.045, n=24) and MIR (IDA) (1.02±0.05 vs. 1.47±0.44, P =0.005, n=24) were both significantly lower in CR patients than in NR patients.

CONCLUSION: Leukemia patients with much higher peripheral WBC count at diagnosis were more difficult to reach remission after induction chemotherapy than patients with lower WBC counts. Age was not influential to chemotherapy results. The determination of MIR value in MDR functional assays is more valuable than expression levels of CD34, P-gp and Bcl-2 in the prediction of chemotherapy outcomes.

Topics:
chemotherapy regimen, leukemia, acute, prognostic factors, apoptosis, drug resistance, multiple, cd34 antigens, p-glycoprotein, disease remission, leukemia, chemotherapy, neoadjuvant

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2005, The American Society of Hematology
2004
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