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Expression of functional markers in acute nonlymphoblastic leukemia
1Department of Clinical Pathology, Catholic University Medical College, Seoul, Korea.
Acta Haematologica
|March 30, 2001
Summary
New functional parameters like Lung Resistance-Associated Protein (LRP) and P-glycoprotein (PGP) can predict acute nonlymphoblastic leukemia (ANLL) behavior. PGP-positive ANLL cases show lower remission rates, aiding in treatment decisions.
Area of Science:
- Hematology
- Oncology
- Molecular Biology
Background:
- Acute nonlymphoblastic leukemia (ANLL) presents challenges in predicting clinical behavior and treatment response.
- Multidrug resistance (MDR) and cellular infiltration are key factors influencing ANLL prognosis.
Purpose of the Study:
- To identify clinically reliable functional parameters for predicting ANLL behavior.
- To correlate specific molecular markers with treatment outcomes and disease characteristics.
Main Methods:
- Flow cytometry was used to analyze MDR parameters, tissue infiltration, colony-stimulating factor receptors (CSFr), and cell cycle markers in 145 ANLL patients (109 initial, 36 relapsed/refractory).
- Expression levels of Lung Resistance-Associated Protein (LRP), P-glycoprotein (PGP), Multidrug Resistance-Associated Protein (MRP), CD44, matrix metalloprotease-2, and cell cycle markers (Ki-67, DNA topoisomerase IIalpha) were assessed.
Main Results:
- LRP (44.1%) and PGP (35.9%) were frequently expressed in ANLL, with higher prevalence in relapsed/refractory cases.
- Complete remission rates were significantly lower in PGP-positive ANLL patients (p = 0.001).
- CD44 positivity correlated with increased relapse frequency; specific infiltration parameters linked to organ tropism (splenomegaly, hepatomegaly).
- Granulocyte-macrophage-CSFr expression was high in M4/M5 subtypes; granulocyte-CSFr positivity was associated with less extramedullary infiltration and more PGP expression.
- Ki-67 was lower in refractory ANLL, while DNA topoisomerase IIalpha was higher in surviving patients.
Conclusions:
- Analysis of MDR proteins (LRP, PGP), cell adhesion molecules (CD44), and cell cycle markers provides valuable insights into ANLL prognosis.
- These functional parameters can aid in predicting and potentially overcoming the clinical behavior of ANLL at diagnosis.
- Understanding these markers may guide personalized treatment strategies for ANLL patients.