[The clinical and biological significance of P-glycoprotein expression in acute nonlymphocytic leukemia].

To evaluate the clinical and biological significance of P-glycoprotein (P-gp) expression in adult acute nonlymphocytic leukemia (ANLL), P-gp was detected in 169 patients including 152 previously untreated cases, 7 refractory cases, and 10 cases at remission by using monoclonal antibody UIC2 and flow cytometry. P-gp was expressed in 29% of previously untreated cases, being less than in 71% of the refractory cases. P-gp expression was not found in patients at remission. Morphologically, P-gp expression was high in hybrid acute leukemia (67%) and acute monoblastic leukemia (47%) subtypes. Immunologically, P-gp expression was significantly associated with CD34, CD7, CD14 or CD42b/CD61. Cytogenetically, P-gp expression was highly associated with poor prognosis abnormalities (54%), which was significantly higher than 7% of P-gp expression in good prognosis abnormalities. 23% of P-gp positive previously untreated ANLL (not including M3) achieved complete remission; this was significantly lower than 76% in P-gp negative cases. These suggested that P-gp expression is an index of poor prognosis in adult ANLL and P-gp positive ANLL has unique clinical and biological features.