Prognostic significance of multidrug resistance gene 1 (MDR1), multidrug resistance-related protein (MRP) and lung resistance protein (LRP) mRNA expression in acute leukemia

• Published in: Journal of Korean medical science 2006-04, Vol.21 (2), p.253-258
• Main Authors: Huh, Hee Jin, Park, Chan Jeoung, Jang, Seongsoo, Seo, Eul Ju, Chi, Hyun Sook, Lee, Je Hwan, Lee, Kyoo Hyung, Seo, Jong Jin, Moon, Hyung Nam, Ghim, Thad
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Base Sequence; Child; Child, Preschool; Female; Gene Expression; Genes, MDR; Humans; Infant; Leukemia - drug therapy; Leukemia - genetics; Leukemia - mortality; Leukemia, Myeloid, Acute - drug therapy; Leukemia, Myeloid, Acute - genetics; Leukemia, Myeloid, Acute - mortality; Male; Middle Aged; Multidrug Resistance-Associated Proteins - genetics; Neoplasm Proteins - genetics; Original; Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy; Precursor Cell Lymphoblastic Leukemia-Lymphoma - genetics; Precursor Cell Lymphoblastic Leukemia-Lymphoma - mortality; Prognosis; RNA, Messenger - genetics; RNA, Neoplasm - genetics; Survival Rate; Vault Ribonucleoprotein Particles - genetics
• ISSN: 1011-8934; 1598-6357
• DOI: 10.3346/jkms.2006.21.2.253

The prognostic significance of multidrug resistance (MDR) gene expression is controversial. We investigated whether multidrug resistance gene 1 (MDR1), multidrug resistance-related protein (MRP) and lung resistance protein (LRP) mRNA expression are associated with outcomes in acute leukemia patients. At diagnosis we examined MDR1, MRP and LRP mRNA expression in bone marrow samples from 71 acute leukemia patients (39 myeloid, 32 lymphoblastic) using nested RT-PCR. The expression of each of these genes was then expressed as a ratio in relation to beta-actin gene expression, and the three genes were categorized as being either 0, 1+, 2+ or 3+. MDR1, MRP and LRP mRNA expression was detected in 23.9%, 83.1% and 45.1 %, respectively. LRP mRNA expression was significantly associated with resistance to induction chemotherapy in acute leukemia patients, and in the AML proportion (p=0.02 and p=0.03, respectively). MRP and high MDR1 mRNA expression was associated with poorer 2-yr survival (p=0.049 and p=0.04, respectively). Patients expressing both MRP and LRP mRNA had poorer outcomes and had worse 2-yr survival. The present data suggest that MDR expression affects complete remission and survival rates in acute leukemia patients. Thus, determination of MDR gene expression at diagnosis appears likely to provide useful prognostic information for acute leukemia patients.