Multidrug resistance in haematological malignancies (Reprinted from Journal of Internal Medicine, vol 247, pg 521-534, 2000)

The development of refractory disease in acute myeloid or lymphoblastic leu kaemias (AML, ALL) and multiple myeloma (MM) is frequently associated with the expression of one or several multidrug resistance (MDR) genes, MDR1, MR P1 and LRP have been identified as important adverse prognostic factors in AML, T-ALL and MM. Recently, it has become possible to reverse clinical mul tidrug resistance by blocking P-glycoprotein-mediated drug efflux, The pote ntial relevance of these reversal agents of MDR and potential new approache s to treat refractory disease are discussed.