Drug resistance mechanisms in leukaemia

Although considerable advances have been made over the past 20 years in the treatment of leukaemia, many patients still die either of their disease, or of the attempts made to cure it. A major contribution to this unacceptable level of mortality is the presence of drug resistance in the residual leukaemic cells. Although many laboratory studies have been performed which have indicated possible cellular mechanisms for the development of resistance, comparatively little is known of the relevance of these processes to resistance as it occurs in patients. Information from such studies should provide a basis for the rational design of agents capable of reversing resistance, and thereby improving the chances of achieving sustainable remission in the majority of patients presenting with leukaemia.