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document
Cyclosporine inhibition of P-glycoprotein in chronic myeloid leukemia blast phase . Chronic myeloid leukemia blast phase ( CML-BP ) cells commonly express the multidrug transporter , P-glycoprotein ( Pgp ) . To determine whether Pgp inhibition improves treatment outcome in CML-BP , the Southwest Oncology Group performed a randomized , controlled trial testing the benefit of the Pgp modulator , cyclosporin A ( CsA ) . Seventy-three eligible patients were assigned to treatment with cytarabine and infusional daunorubicin with or without intravenous CsA . Treatment with CsA yielded no improvement in treatment outcome as measured by the frequency of induction resistance ( 68 % vs 53 % ) , rate of complete remission or restored chronic phase ( CR/CP , 8 % vs 30 % ) , and survival ( 3 vs 5 months ) . Blast expression of Pgp ( 63 % ) and LRP ( 71 % ) was common , whereas only Pgp adversely impacted the rate of CR/CP ( P =.025 ) . We conclude that Pgp has prognostic relevance in CML-BP but that the modulation of Pgp function with CsA as applied in this trial is ineffective .
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Intervention_Pharmacological
Cyclosporine
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Intervention_Pharmacological
Pgp modulator
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Intervention_Pharmacological
cyclosporin A ( CsA )
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Intervention_Pharmacological
cytarabine and infusional daunorubicin with or without intravenous CsA
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Outcome_Other
no improvement
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Outcome_Physical
frequency of induction resistance
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Outcome_Physical
rate of complete remission
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Outcome_Physical
restored chronic phase
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Outcome_Mortality
survival
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Outcome_Physical
Blast expression of Pgp
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Outcome_Physical
LRP
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Outcome_Physical
rate of CR/CP
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Participant_Condition
chronic myeloid leukemia blast phase
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Participant_Sample-size
Seventy-three