The expression of the resistance-related proteins P-glycoprotein 170 (
P-170) glutathione-S-transferase pi (GST-pi) topoisomerase II (Topo II
), thymidylate synthase (TS) and metallothionein (MT) was investigated
in leukemic cells of 19 children with newly diagnosed acute nonlympho
blastic leukemia. P-170 was expressed in 84 % GST-pi in 37 % TS in 47
% MT in 68 % and Topo II was downregulated in 37 % of the cases invest
igated. No resistance factors were found in two patients, one positive
factor was found in two patients three factors in three patients, fou
r factors in 7 patients, and all resistance factors investigated were
present in one patient. Patients who developed a relapse expressed mor
e than two resistance mechanisms significantly more often than patient
s who remained in remission (p=0,005). The probability of continuous f
irst remission was significantly lower where more than two resistance
mechanisms were expressed. The results indicate that the higher the nu
mber of resistance-related proteins in childhood ANLL the poorer the p
rognosis of the patients.