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P-glycoprotein expression in plasma-cell myeloma is associated with
resistance to VAD
J Epstein, HQ Xiao and BK Oba
University of Texas M.D. Anderson Cancer Center, Department of Hematology,
Houston 77030.
Tumor cell-associated expression of multidrug resistance (MDR) was
quantitated in 22 patients with DNA-aneuploid myeloma using 2-parameter
flow cytometry with monoclonal antibody (MoAb) C-219 for the detection of
cytoplasmic p-170 and propidium iodide for nuclear DNA content. The
proportion of cells expressing p-170 and the intensity of p-170-related
fluorescence were determined for each patient. Among the 14 patients
treated with vincristine-adriamycin-dexamethasone (VAD), the proportion of
p-170-positive cells distinguished sensitive from resistant disease (P less
than .01). Among a subgroup of seven patients with MDR analysis available
prior to VAD therapy, two subsequent nonresponders had high proportions of
C-219-reactive cells. The presence de novo of high proportions of
p-170-expressing cells in another still untreated patient and in a further
individual with resistance to dexamethasone and interferon (not associated
with MDR) warrants systematic analysis of p-170 expression prior to therapy
to determine its clinical implications for response to MDR-associated drugs
as combined in the VAD regimen. Concurrent MDR expression by aneuploid
tumor cells and cells in the diploid subcompartment may represent
involvement of diploid cells in the myeloma disease process.
Volume 74,
Issue 3,
pp. 913-917,
08/15/1989
Copyright © 1989 by The American Society of Hematology
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