Idarubicin is superior to daunorubicin in remission induction of de novo acute myeloid leukemia patients with high MDR1 expression

Author:

Shi Pengcheng1,Zha Jie1,Guo Xutao1,Chen Feili1,Fan Zhiping1,Huang Fen1,Meng Fanyi1,Liu Xiaoli1,Feng Ru1,Xu Bing2

Affiliation:

1. Department of Hematology, Nanfang Hospital, Southern Medical University, 510515 Guangzhou, China

2. Department of Hematology, Nanfang Hospital, Southern Medical University, 510515 Guangzhou, China.

Abstract

Aim: To investigate whether idarubicin in a cytarabine-based induction regimen was superior to daunorubicin in de novo acute myeloid leukemia patients expressing high MDR1. Patients & methods: The clinicopathological data were analyzed in 125 patients receiving daunorubicin or idarubicin with cytarabine for remission induction. Median MDR1 mRNA expression in pretreated bone marrow cells was used as the cutoff point for high and low MDR1 expression. Results: A total of 59.7% high and 77.8% low MDR1 expressers achieved complete remission (CR; p = 0.029). Idarubicin yielded a higher CR rate than daunorubicin in high MDR1 expressers (82.1 vs 41.2%; p = 0.001), it also demonstrated a higher CR rate than daunorubicin (p < 0.05) in high MDR1 expressers exhibiting favorable or intermediate risk, while there was no difference between the two treatment arms in low MDR1 expressers exhibiting either favorable or intermediate risk. Conclusion: Idarubicin is associated with better remission induction of de novo acute myeloid leukemia patients with high MDR1 expression. Original submitted 23 May 2012; Revision submitted 10 October 2012

Publisher

Future Medicine Ltd

Subject

Pharmacology,Genetics,Molecular Medicine

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