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[Multidrug resistance in acute leukemia]

A Takeshita1, R Ohno

  • 1Department of Internal Medicine III, Hamamatu University School of Medicine.

[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology
|August 1, 1996
PubMed
Summary

Multidrug resistance P-glycoprotein (P-gp) expression decreases with myeloid cell maturation in both normal bone marrow and acute myeloid leukemia (AML) cells. P-gp levels increase in relapsed AML, particularly on CD34+CD33- cells.

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Area of Science:

  • Hematology
  • Molecular Biology
  • Cancer Research

Background:

  • Multidrug resistance (MDR) mediated by P-glycoprotein (P-gp) is a significant challenge in acute myeloid leukemia (AML) treatment.
  • Understanding P-gp expression patterns in different cell populations is crucial for developing effective therapeutic strategies.

Purpose of the Study:

  • To investigate the expression of P-glycoprotein (P-gp) on normal bone marrow (BM) cells and acute myeloid leukemia (AML) cells.
  • To analyze P-gp expression in relation to myeloid cell maturation markers (CD33, CD34) and its changes in AML subtypes and during relapse.

Main Methods:

  • Utilized a newly devised multi-parameter flow cytometric analysis.
  • Employed CD33, CD34 monoclonal antibodies, and biotinylated MRK16 antibody with Streptavidin-RED670 (SA-RED670) conjugate for P-gp detection.
  • Performed precise list-mode analysis to quantify P-gp expression on distinct cell subpopulations.

Main Results:

  • Normal bone marrow (BM) cells showed decreasing P-gp expression with myeloid cell maturation (CD34+CD33- > CD34+CD33+ > CD34-CD33+).
  • AML cells at diagnosis exhibited a similar P-gp expression trend, with CD34+CD33- cells showing strong expression.
  • Acute promyelocytic leukemia (APL) blasts expressed less P-gp compared to other AML subtypes; P-gp expression increased in relapsed AML, especially on CD34+CD33- cells.

Conclusions:

  • P-glycoprotein (P-gp) expression is inversely correlated with myeloid cell maturation in both normal hematopoiesis and AML.
  • P-gp expression patterns differ among AML subtypes and are significantly upregulated in relapsed disease, highlighting its potential role in therapeutic resistance.
  • The findings provide insights into P-gp heterogeneity in AML and suggest potential targets for overcoming multidrug resistance.

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