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  • Title: Drug-resistance Profile in Multiple-relapsed Childhood Acute Lymphoblastic Leukemia.
    Author: Pogorzala M, Kubicka M, Rafinska B, Wysocki M, Styczynski J.
    Journal: Anticancer Res; 2015 Oct; 35(10):5667-70. PubMed ID: 26408741.
    Abstract:
    AIM: To analyze the drug-resistance profile at first and subsequent relapse in children with acute lymphoblastic leukemia (ALL). PATIENTS AND METHODS: A total of 154 pediatric ALL samples were tested for ex vivo chemosensitivity for up to 19 drugs. Their combined drug resistance profile (PVA score) was analyzed. RESULTS: The median relative resistance scores between patients with multiple relapse and those with first relapse considering all drugs was 2.0. The median PVA score at subsequent relapses was 8 vs. 6 at first relapse (p=0.004). Samples from multiple-relapsed ALL were more drug resistant to: prednisolone (>1.9-fold), dexamethasone (>1.5-fold), vincristine (3.1-fold), L-asparaginase (5-fold), mitoxantrone (2.4-fold), cytarabine (4.3-fold), mercaptopurine (2.2-fold), thioguanine (4.8-fold), etoposide (2.6-fold) and melphalan (2.7-fold). Lymphoblasts at multiple relapse were comparably resistant to: daunorubicin, doxorubicin, cyclophosphamide, ifosfamide, busulfan, treosulfan, fludarabine, clofarabine and bortezomib. CONCLUSION: In comparison to first relapse, subsequent relapsed childhood ALL is more ex vivo-resistant to most tested drugs.
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