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Sensitivity and Resistance to Therapy

MDR1 expression in poor-risk acute myeloid leukemia with partial or complete monosomy 7

Leukemia volume 15, pages 398–405 (2001)Cite this article

Abstract

Expression of the multidrug resistance (MDR1) phenotype, encoded by the MDR1 gene, is an adverse prognostic factor for CR and survival in acute myeloid leukemia (AML). Other prognostic factors, such as specific cytogenetic abnormalities, have been identified in AML. We have investigated the expression of the MDR1 gene in untreated AML patients with monosomy 7 (n = 12), and partial deletions (n = 7) of the long arm of chromosome 7 (respectively −7/7q−), because of the extremely bad prognosis associated with these cytogenetic abnormalities and because of the fact that the MDR1 gene is located on chromosome 7q21.1. The findings were compared with the level of MDR1 expression in a group of 42 other AML patients, matched for age with favourable, neutral or complex cytogenetic abberations. MDR1 mRNA expression, as measured by the RNase protection assay was significantly higher in the −7/7q− group vs other AML patients (median 1.3 vs 0.1 arbitrary units, P = 0.02). Protein expression of MDR1 in the −7/7q− group, as determined with the monoclonal antibody MRK16, was found to be similar to the levels found in the control group. With a functional rhodamine retention assay using the modulator PSC833, increased MDR1 activity was observed in the −7/7q− group as compared to the control group of patients (P = 0.05). Considering the higher MDR1 mRNA expression and equal or slightly elevated level of protein expression of MDR1, we studied the presence of MDR1 genes in this group of −7/7q− patients. Fluorescence in situ hybridization (FISH) studies, using a specific MDR1 probe revealed no loss of an MDR1 allele in any of the deleted q− arms of the seven patients with 7q−, whereas all monosomy 7 patients lacked one MDR1 gene homologue. To determine whether there was selective loss of the MDR1 gene in the −7/7q− patients, the genetic polymorphism of the MDR1 gene was used. Both allelic variants (G and T) were represented in the −7/7q− and in the control group, showing a predominance for GT at position 2677 of the MDR1 gene in the control group. In the 12 monosomy 7 patients loss of the MDR1 allele was random. Methylation studies of the CpG island of the MDR1 gene revealed no hypermethylation in any of the −7/7q− patients. We conclude that MDR1 expression in −7/7q− AML patients is upregulated at transcriptional, but not at translational level, suggesting that mechanisms other than MDR1 are responsible for the poor prognosis in these patients.

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Acknowledgements

This study was supported by the Foundation of Medical Research Sophia (SSWO), the Kröger Society and the Foundation of Pediatric Oncology Centre Rotterdam (SKOR). The authors express their gratitude to Drs F Baas and Dr P Devilee for providing the MDR1-specific FISH probe and the centromer probe of chromosome 7. They also thank the technicians of the Tumorcytogenetics laboratory, Department of Clinical Genetics, and Department of Cell biology and Genetics for their expert technical assistance.

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Authors and Affiliations

  1. Department of Hematology, University Hospital and Erasmus University, Rotterdam, The Netherlands

    MM van den Heuvel-Eibrink, EAC Wiemer, MJ de Boevere, M Schoester & P Sonneveld

  2. Department of Pediatric Oncology/Hematology, University Hospital and Erasmus University, Rotterdam, The Netherlands

    MM van den Heuvel-Eibrink, MM van Noesel & R Pieters

  3. Department of Clinical Genetics, University Hospital and Erasmus University, Rotterdam, The Netherlands

    RM Slater & EME Smit

  4. Department of Cell Biology and Genetics, University Hospital and Erasmus University, Rotterdam, The Netherlands

    RM Slater

  5. Department of Statistics, University Hospital and Erasmus University, Rotterdam, The Netherlands

    B van der Holt

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van den Heuvel-Eibrink, M., Wiemer, E., de Boevere, M. et al. MDR1 expression in poor-risk acute myeloid leukemia with partial or complete monosomy 7. Leukemia 15, 398–405 (2001). https://doi.org/10.1038/sj.leu.2402027

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