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Drug resistance factors in acute myeloid leukemia: a comparative analysis

Leukemia volume 14, pages 68–76 (2000)Cite this article

Abstract

To compare the clinical relevance of drug resistance factors in de novo acute myeloid leukemia (AML), we determined their relationship to both response to induction chemotherapy and survival of the patients in univariate as well as multivariate analyses. The drug resistance factors immunocytochemically studied in 111 patients at the time of diagnosis included the lung resistance protein (LRP), P-glycoprotein (P-gp), multidrug resistance protein (MRP1) and bcl-2. In the univariate analyses, age (P = 0.005), karyotype (P = 0.03), LRP (P = 0.003), P-gp (P = 0.02) and bcl-2 (P = 0.03) predicted for response to induction chemotherapy, whereas MRP1 had no predictive value. Age (P = 0.05), karyotype (P = 0.05) and LRP (P = 0.03) retained their predictive value in the multivariate logistic regression analyses. With regard to overall survival, age (P = 0.008), karyotype (P = 0.006), LRP (P = 0.001) and P-gp (P = 0.01) were of prognostic value in the univariate Cox regression analyses but only age (P = 0.01), karyotype (P = 0.02) and LRP (P = 0.01) retained their prognostic significance in the multivariate analyses. A risk score based on the number of independent prognostic factors allowed division of patients into four groups with different outcome. In these groups, the complete remission rates were 93%, 75%, 47% and 33%, respectively, and median overall survival was 2.4, 1.2, 0.6 and 0.2 years, respectively. Thus, several drug resistance factors did predict outcome in the univariate analyses but LRP was the only drug resistance factor with independent predictive and prognostic significance. The proposed risk score might be useful for risk-adapted treatment in the future.

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Acknowledgements

This study was supported by the ‘Fonds zur Förderung der wissenschaftlichen Forschung’ (project number P12264-MED).

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Authors and Affiliations

  1. Division of Oncology, Department of Internal Medicine I, University of Vienna Medical School, Austria

    M Filipits, T Stranzl, G Pohl & R Pirker

  2. Division of Hematology, Department of Internal Medicine I, University of Vienna Medical School, Austria

    U Jäger, K Geissler & K Lechner

  3. Department of Medical Computer Sciences, University of Vienna Medical School, Austria

    H Heinzl

  4. Department of Medical Biology, University of Vienna Medical School, Austria

    C Fonatsch

  5. St Anna Kinderspital, Vienna, Austria

    OA Haas

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Filipits, M., Stranzl, T., Pohl, G. et al. Drug resistance factors in acute myeloid leukemia: a comparative analysis. Leukemia 14, 68–76 (2000). https://doi.org/10.1038/sj.leu.2401634

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