Holmes J A, West R R
Department of Haematology, University of Wales College of Medicine, Heath Park, Cardiff, UK.
Br J Cancer. 1994 Feb;69(2):382-4. doi: 10.1038/bjc.1994.70.
Resistance to cytotoxic agents may be encountered during the treatment of acute myeloblastic leukaemia (AML). P-glycoprotein encoded by the MDR-1 gene has been implicated as a potential drug resistance mechanism in leukaemic cells. In recent years, many data have been accrued concerning the expression of P-glycoprotein in leukaemia, and several studies have been published which have related MDR status to outcome in AML. Conclusions as to the effect of P-glycoprotein expression on prognosis in AML have varied widely. The studies are not immediately comparable, since they differ in methodology, treatment regimens, demographic profile and, perhaps most importantly, criteria for positivity of MDR status. The technique of statistical overview (meta-analysis) can be used to pool observational studies. Application of this statistical method to existing studies suggests an estimated relative risk of 0.68 for P-glycoprotein expression with respect to complete remission in AML. Further large studies are required to determine fully the role of P-glycoprotein in AML.
在急性髓细胞白血病（AML）的治疗过程中可能会遇到对细胞毒性药物的耐药性。由MDR-1基因编码的P-糖蛋白被认为是白血病细胞中一种潜在的耐药机制。近年来，已经积累了许多关于白血病中P-糖蛋白表达的数据，并且发表了几项将多药耐药状态与AML预后相关联的研究。关于P-糖蛋白表达对AML预后影响的结论差异很大。这些研究不能直接进行比较，因为它们在方法、治疗方案、人口统计学特征方面存在差异，也许最重要的是，多药耐药状态阳性的标准不同。统计综述（荟萃分析）技术可用于汇总观察性研究。将这种统计方法应用于现有研究表明，AML中P-糖蛋白表达相对于完全缓解的估计相对风险为0.68。需要进一步开展大型研究以全面确定P-糖蛋白在AML中的作用。
