Clinical Significance Of HA117,MDR1,MRP1,LRP And BCRP Expression In Children With Acute Leukemia

Object:To explore the expression of the HA117、mdr1、mrp1、1rp and bcrp genes in bone marrow mononuclear cells(BMMNC)with acute leukemia and the clinical significance in acute leukemia.Methods:Expressions of HA117,mdrl,mrp1,1rp and bcrp in81children with acute leukemia and14children with Idiopathic thrombocytopenic purpura (ITP) were tested using semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR) technique and Quantitative real-time PCR.Results:①The result,which was positive expression of gene HA117,mdrl, mrp1,1p and bcrp in the initially diagnosed, the remission, the refractory-relapsed and the control group respectively,shows as follows:14.3%,35.7%,42.8%,28.6%,35.7%;38.5%,69.2%,84.6%,74.3%,59.0%;18.9%,56.8%,86.4%,89.1%m64.9%;40.0%,80.0%,100%,80.0%,80.0%. ②The positive expressions of the genes in AL were higher than in the control group. And the positive expressions of the genes in the refractory-relapsed were higher than in the initially diagnosed or in the remission.③The first complete remission (CR1) rate in HA117and lrp positive cases was lower than it in negative cases(P<0.05), but the CR1rates in mdr1、mrp1and bcrp positive cases had no significant difference from it in negative cases(P>0.05).④The expression rates and expression levels of HA117,mdrl,mrpl, lrp and bcrp were higher in standard-risk group or middle-risk group or high-risk group compared with the control group (P<0.05). But there were no significant difference in expressions of the genes in standard-risk group from middle-risk group or high-risk group(P>0.05)⑤The expression levels of HA117,mdrl,mrpl,1rp and bcrp in ALL and AML were higher than in the control group(P<0.05). And the expression levels of HA117,mdr1and mrpl in ALL were higher than in AML (P<0.05). And the expression levels of lrp and bcrp in ALL were lower than in AML(P>0.05)⑥The expression levels of genes in AL were higher than in the control group, And the expression levels of genes in the refractory-relapsed were highest between AL(P<0.05). The refractory-relapsed patients had higher expression of HA117compared with initially diagnosed patients and remission patients (P<0.05).And the initially diagnosed patients had higher expression of mdrl and mrpl compared with remission patients(P<0.01),but no significant difference from refractory-relapsed patients;and the refractory-relapsed patients had higher expression than remission patients (P<0.05).And the initially diagnosed patients had higher expression of lrp compared with remission patients(P<0.05),and the refractory-relapsed patients had higher expression of1rp compared with initially diagnosed patients or remission patients, but no significant difference from initially diagnosed or remission patients. The initially diagnosed patients no significant difference expression of bcrp from remission or refractory-relapsed patients,but the refractory-relapsed patients had higher expression compared with remission patients(P<0.05).⑦Correlation analysis showed:There was no correlation between the expression of HA117and mdrl or HA117and mrpl or HA117and lrp or HA117and bcrp in childhood acute leukemia. mdrl and mrpl or mdr1and bcrp or1rp and bcrp had obviously positive correlation (correlation coefficient=0.26、0.308、0.317, P<0.05).In refractory-relapsed group,HA117and mdr1or mrp1or1rp or bcrp had obviously perfect positive correlation.Conclusion:①Expressions of HA117,mdrl,mrpl,lrp and bcrp in AL increased. Expressions of them obviously increased in the refractory-relapsed. ②In refractory-relapsed group,HA117and mdr1or mrp1or lrp or bcrp had obviously perfect positive correlation. And the first complete remission (CR1) rate in five genes positive cases was lower than it in negative cases. Maybe the gene HA117,mdr1,mrp1,1rp and bcrp associated with multidrug resistance of acute leukemia in children. Therefore HA117could be regard as one of the important indexes to evaluate chemotherapy effect and prognosis.