Journal
LEUKEMIA & LYMPHOMA
Volume 45, Issue 11, Pages 2221-2228Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/10428190412331272767
Keywords
multidrug resistance; P-glycoprotein; JC-1; rhodamine 123; acute leukemia; flow cytometry
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One of the possible causes of treatment failure in acute leukemia is the emergence of multidrug resistance caused by P-glycoprotein (P-gp) overexpression. We compared a flow cytometric assay using JC-1 with a technique using rhodamine 123 (rho123) to evaluate the P-gp function in acute leukemia. Samples from 50 acute leukemia patients were analyzed by both functional assays. The P-gp expression was assessed by an immunological flow cytometric test and the association between the P-gp status and the clinical outcome was evaluated. Of all samples, 28% showed a reversible JC-1 efflux and 36% scored positive for the rho123 assay. In two cases, the leukemic blasts showed a reversible JC-1 efflux whereas they were negative for rho123. These patients had blast cells with a very low P-gp activity. Six samples scored positive for the rho123 assay but were negative for the JC-1 test. Five of these samples did not express P-glycoprotein and were considered false positive. We found a strong correlation between the JC-1 and the rho123 test (R-s = 0.59, p < 0.0001) and the JC-1 and the immunological assay (R-s = 0.29, P = 0.05). There was also an association between the JC-1 status and the clinical outcome of adult patients (chi(2) = 6.30, P = 0.04). In conclusion, we recommend the JC-1 assay to study the P-gp activity in acute leukemia because it is more specific and less labor intensive than conventional functional flow cytometric tests using rhodamine 123. In addition, the JC-1 assay can be used to identify adult patients with an increased risk for adverse clinical outcome.
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