• Frouzandeh Mahjoubi, Masoud Golalipour, Ardeshir Ghavamzadeh, and Kamran Alimoghaddam.
• Department of Clinical Genetics, Oncology and Stem Cell Research Center, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran. frouz@nrcgeb.ac.ir
• Sao Paulo Med J. 2008 May 1; 126 (3): 172179172-9.

Context And ObjectiveOverexpression of the multidrug resistance-associated protein 1 (MRP1) gene has been linked with resistance to chemotherapy in vitro, but little is known about its clinical impact on acute leukemia patients. Our aim was to investigate the possible association between MRP1 gene expression level and clinical outcomes among Iranian leukemia patients.Design And SettingThis was an analytical cross-sectional study on patients referred to the Hematology, Oncology and Stem Cell Research Center, Sharyatee Public Hospital, whose diagnosis was acute myelogenous leukemia (AML) or acute lymphoblastic leukemia (ALL). All molecular work was performed at NIGEB (public institution).MethodsTo correlate with prognostic markers and the clinical outcome of acute leukemia, MRP1 gene expression was assessed in 35 AML cases and 17 ALL cases, using the quantitative real-time polymerase chain reaction and comparing this to the chemotherapy response type.ResultsMean expression in AML patients in complete remission (0.032 +/- 0.031) was significantly lower than in relapsed cases (0.422 +/- 0.297). In contrast, no significant difference in MRP1 mRNA level was observed between complete remission and relapsed ALL patients. There was a difference in MRP1 expression between patients with unfavorable and favorable cytogenetic prognosis (0.670 +/- 0.074 and 0.028 +/- 0.013, respectively). MRP1 expression in M5 was significantly higher (p-value = 0.001) than in other subtypes.ConclusionsThe findings suggest that high MRP1 expression was associated with poor clinical outcome and was correlated with the M5 subtype and poor cytogenetic subgroups among AML patients but not among ALL patients.

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