In vitro cellular drug resistance and prognosis in newly diagnosed childhood acute lymphoblastic leukemia

被引:237
作者
Kaspers, GJL
Veerman, AJP
Pieters, R
VanZantwijk, CH
Smets, LA
VanWering, ER
DenBerg, AV
机构
[1] DUTCH CHILDHOOD LEUKEMIA STUDY GRP, THE HAGUE, NETHERLANDS
[2] NETHERLANDS CANC INST, AMSTERDAM, NETHERLANDS
关键词
D O I
10.1182/blood.V90.7.2723.2723_2723_2729
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
As an important determinant of the response to chemotherapy, measurements of cellular drug resistance may provide prognostically significant information, which could be useful for optimal risk-group stratification. The objective of this report is to determine the relation between in vitro resistance to 12 drugs, measured with the calorimetric methylthiazol-tetrazolium (MTT) assay, and long-term clinical response to chemotherapy in 152 children with newly diagnosed acute lymphoblastic leukemia. At risk-group stratified analyses, in vitro resistance to prednisolone, L-asparaginase, and vincristine were each significantly (P <.01) related to the probability of disease-free survival (pDFS) after combination chemotherapy. The combination of data for prednisolone, L-asparaginase, and vincristine provided 8 drug-resistance profile with prognostic independent significance superior to that of any single drug or any other factor. The 3-years pDFS was 100% for the group with the most sensitive profile, 20% of all patients, 84% (SE 6%) for the group with an intermediately sensitive profile, 40% of all patients, and 43% (SE 8%) for the remaining group with the most resistant profile (P <.001). In conclusion, the extent of in vitro cellular resistance to prednisolone. L-asparaginase, and vincristine, measured using the MTT assay, was significantly related to the clinical response to combination chemotherapy. Treatment failure in newly diagnosed childhood ALL can be predicted based on cellular drug resistance data. (C) 1997 by The American Society of Hematology.
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页码:2723 / 2729
页数:7
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