The Clinical Studies Of Expressions Of Fas,P-gp And Mdr1 And The Correlations Of Their Expressions In Acute Leukemia

[Objective] To explore the role of expressions of Fas, P-glycoprotein(P-gp) and mdrl in Acute Leukemia(AL) and the correlations of expressions of these three factors in AL. [Methods] 1, We detected Fas/Apo-1 and P-gp from 59 newly diagnosed AL patients before treatment and after CR with Flow Cytometry(FCM) . 2, Reverse transcription-polymerase chain reaction (RT-PCR) method was developed to semi-quantitate mdrl messenger(mRNA)of 59 AL.[Resultes] 1, In newly diagnosed AL patients,the Fas expression in Acute Myeloid Leukemia(AML) was higher than in Acute Lymphocytic Leukemia(ALL) (P<0.05 ); the expressions of P-gp and mdrl in AML and ALL had no difference(P>0.05). 2, The expressions of Fas and P-gp had obviously negtive correlation(r=-0.423,P<0.01) in AL and also in AML(r=-0.463,P<0.01);the expressions of Fas and mdrl still had correlation(r=-0.282, P <0.05) in AL;and that of P-gp and mdrl showed their obviously positive correlation in AML,ALL and AL(r=0.832,P<0.01). 3 , Our studies showed that higher expressions of CD34 in AML-M2 and M5 and they had no difference in AML and ALL.In AML and AL,CD34+ and CD34- haddifference in CR rates(P<0.05);In ALL,they had no difference (P>0.05).They also showed no correlation with expressions of CD34 and Fas(r=-0.05,P>0.05),but showed significant positive correlation with expression of CD34 when compared with P-gp(r=1.277, P<0.05)andmdrl(r=1.278, P <0.05). 4, Fas was highly associated with unfavorable karyotype(r=-3.096, P<0.01),P-gp and mdr 1 were associated with them,too (r=2.461, 2.283,P<0.05, P<0.05).In contrast to Fas,P-gp and mdr 1, there were no correlation with age, sex, WBCs, marrow blasts percentage and enlargement of liver, spleen and lymph nuts(P>0.05) except that Fas expression had correlation with the enlargement of liver , spleen and lymph nuts(P<0.05). 5, The resultes of simple-variate COX regression modles showedrthe expressions of Fas , P-gp, mdr1 and CD34,all of them had significant association with the effect of therapy.A multivariate COX survival factor modle analysis showed Fas and mdrl expressions are prognostic factor for response and survival. 6, By Log rank test,comparing the groups of Fas+ with Fas-,P-gp+ with P-gp", mdr1+ with mdrl-, we found that the complete remission(CR) rates and median remission time of every two groups had obvious difference(chi-square were 7.35,11.05,10.71,and P were 0.0067,0.0009,0.0011 in turn). [Conclusions] 1, In AL,Fas and mdrl expressions had highly correlation with the effect of treatment. 2, The expression ofFas probably is one of the favorablely prognostic factors. 3, CD34+ is a low-CR-rate and poorly prognostic factor. 4, P-gp and mdrl are important factors of unfavorable prognost and poor effect of treatment.