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Multidrug Resistance in Acute Myeloid Leukemia: Potential New Therapeutics

In acute myeloid leukemias (AMLs), multidrug resistance (MDR) is frequently, but not always, caused by the MDR1 gene product, a 170to 180kDa glycoprotein known as P-glycoprotein (Pgp) or human MDR1 protein (1). It is characterized by broad resistance to several structurally, chemically, and pharmacologically distinct chemotherapeutic compounds. Many theories explain how Pgp affects MDR, including the ‘‘drug pump’’ model, in which Pgp hydrolyzes adenosine triphosphate to actively pump drugs out of the cell (2,3). As many MDR cells have been found to have