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Clinical significance of multidrug resistance P-glycoprotein expression on
acute nonlymphoblastic leukemia cells at diagnosis [see comments]
L Campos, D Guyotat, E Archimbaud, P Calmard-Oriol, T Tsuruo, J Troncy, D Treille and D Fiere
Service de Cryobiologie, Centre de Transfusion Sanguine, Lyon, France.
To evaluate the clinical value of the expression of multidrug resistance
P-glycoprotein (P-170) on the surface of acute nonlymphoblastic leukemia
(ANLL) cells, we analyzed specimens from 150 newly diagnosed patients for
staining with MRK16, a monoclonal antibody (MoAb) that binds to an external
epitope of P-170. Other surface markers (CD13, CD14, CD15, and CD34) were
studied by the same technique. A marker was considered positive when 20% or
more cells were stained. Of 150 samples, 71 were P-170-positive. These
cases did not differ from P-170-negative cases with regard to age, sex,
initial white blood cell (WBC) counts, or French-American-British (FAB)
type (except for M3 ANLL, which were more frequently negative). However,
leukemias arising from previous myelodysplastic syndrome (MDS) and therapy-
induced leukemias were more frequently P-170-positive. CD34 and P-170
expression were significantly associated. All patients were treated by
intensive chemotherapy. Complete remission (CR) rates were significantly
lower in P-170-positive (23/71, 32%) than in P-170- negative cases (64/79,
81%) (P less than 10(-5)). CD34 positivity was also associated with a low
remission rate (P less than 10(-5)). Survival was shorter for P-170- and
CD34-positive patients (P less than 10(-5)). The prognostic value of both
markers was confirmed in multivariate analysis. CR duration was also
shorter for P-170-positive cases, but the difference is less significant (P
= .05). It is concluded that P-170 analysis may be an important tool for
predicting the outcome of intensive chemotherapy in ANLL patients.
Volume 79,
Issue 2,
pp. 473-476,
01/15/1992
Copyright © 1992 by The American Society of Hematology
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