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Do ABC proteins still have a role to play in acute myeloid leukemia? Volume 20, issue 5, Septembre-Octobre 2014

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Authors
Service d’hématologie clinique et de thérapie cellulaire,
hôpital Saint-Antoine,
APHP, Paris
UPMC, université Paris 6,
GRC n° 7,
groupe de recherche clinique sur les myéloproliférations aiguës et chroniques (MYPAC),
Paris, France
* Tirés à part

Drug resistance is a major concern in the treatment of acute myeloid leukemia (AML). Multiple mechanisms that can lead to chemo resistance in AML have been described, and many of them have not been elucidated yet. Among them, the role of the ATB-binding-cassette (ABC) protein family has been investigated since the 1980s. If the Multi Drug Resistance (MDR) phenotype was initially associated with ABCB1 expression, many of the 49 members the ABC proteins seem to be implied in chemo-resistance. In this review, we will describe the role of ABC proteins in haematopoiesis, and discuss of their value to determine the probability of response to treatment in AML. We will also discuss their prognostic value when compared to other well known prognosis factors, and especially to molecular markers like FLT3, NPM1 or CEBPA. At last, we will review the different clinical trials including ABC proteins modulators, and discuss how ABC-mediated resistance could be overruled.