The Correlation of Cyclin A with Drug Resistance in Adult Acute Non Lymphoblastic Leukemia
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- Category: Vol. 77, June 2009
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The Correlation of Cyclin A with Drug Resistance in Adult Acute Non Lymphoblastic Leukemia, FARIDA G. ALLAH, SONYA F. ARSANYOUS, MAHA A. EL-TAWEEL, HISHAM SHAHEEN, OLA M. EL-DESSOUKY, MANAR M. MONEER, AMANY M. HELAL, MOHAMAD M. HAFEZ and MOHAMMAD S. ABBAS
Abstract
Acute Non Lymphoblastic Leukemia is one of the most common malignant tumors of Haematology. With the recent progress in chemotherapy and supportive therapy, the remission and survival rate have been markedly improved.
In this study, Cyclin A2 and multidrug resistance expres-sion was measured by Flow Cytometry and RT-PCR in 52 de novo AML patients with acute myeloid leukemia. Their expression was correlated with other prognostic criteria, response to treatment and to overall survival.
The rate of CR and PR was significantly higher in the group of positive expression of Cyclin A2, compared to that with negative expression. However a statistically significant difference was only reached by PCR (p=0.02). By Flow Cytometry, the overall Survival (OS) in the group with positive Cyclin A2 expression is significantly higher than that in the group of negative Cyclin A2 expression, p=0.03.
Regarding MDR1, it was expressed in 39% of our patients and the level of expression was slightly higher by RT-PCR. The rate of CR and PR in the group of negative MDR expres-sion was significantly higher as compared to the group of positive MDR expression, by both Flow Cytometry and RT-PCR (p=0.005, 0.004, respectively). The OS in the group with negative MDR1 expression was significantly higher than that in the group of positive MDR1 expression, p=0.04.
There was a significant inverse relationship between Cyclin A2 and MDR expression in our AML cases by RT-PCR technique (p=0.005), while it showed no significance by Flow cytometry (p=0.12).
There was no agreement (Kappa=0.25) between Flow cytometry and RT-PCR in detection of Cyclin A2. On the contrary, there was an agreement between Flow cytometry and RT-PCR in detection of MDR.
In conclusion, the low expression of Cyclin A2 and high expression of MDR1 are indicators for unfavorable prognosis for individuals with AML. The detection of Cyclin A2 level would predict drug resistance. However, it is one of many other factors.