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Chin Med J (Taipei) 1997;60:184-90.
1Section of Hematology, Department of Internal Medicine; 2Cancer Research Group, Cancer Center; 3Department of Pathology, Veterans General Hospital-Taipei and National Yang-Ming University, Taipei, Taiwan, R.O.C.
Background. Drug resistance is a major cause of treatment failure in acute leukemia. Overexpression of multidrug resistance gene and decreased activity of topoisomerase IIa are suggested as two important mechanisms for this resistance.
Methods. We used immunohistochemical method to determine the expressions of both topoisomerase II alpha (topo II alpha) and p-glycoprotein (gp-170) in bone marrow biopsy specimens from 68 cases of acute leukemia. Patients were divided into four groups: (1) leukemia cells with high score for topo IIa and negative for gp-170; (2) leukemia cells with high score for topo II alpha and positive for gp-170; (3) leukemia cells with low score for topo II alpha and negative for gp-170; and (4) leukemia cells with low score for topo II alpha and positive for gp-170. The clinical responses were then followed as routine, and the clinical correlation was evaluated by analysis of variance and Pearson Chi-Square test.
Results. The measure of the single parameter (either topo II alpha or gp-170 alone) did not show a significant difference in the overall survival. However, the complete response rate was much higher in the first group patients whose bone marrow reading score was high in topo II alpha and negative for gp-170 expression. Survival duration increased with the increase in the complete response rate.
Conclusions. Combined parameters of topo II alpha and gp-170 are more useful than any individual parameter for the prognosis of acute leukemia.
[Chin Med J (Taipei) 1997;60:184-90.]
Keywords: acute leukemia, DNA topoisomerase IIa, MDR1
Received: October 29, 1996.
Accepted: August 15, 1997.
Address reprint requests to: Kuan-Chih Chow, Ph.D., Cancer Center, Veterans General Hospital-Taipei, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan, R.O.C.
Copyright: 1997, Chinese Medical Association (Taipei)