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To study the expression of P-glycoprotein (P-gp) and the reversal function of As 2 O 3 , the active ingredient of arsenic, on drug resistance in acute myeloid leukemia (AML) patients, P-gp and cluster of differentiation 34 (CD34) were examined in primary mononuclear and resistant cells, with or without As 2 O 3 . In addition, multidrug resistance gene 1 ( MDR1 ) mRNA expression was investigated in K562/D cells and AML patients. In total, 28.6% of newly-treated (NT) patients and 59.1% of relapsed/refractory (RR) patients were P-gp function  + , and 31.7% of NT patients and 59.1% of RR patients were CD34 + . The positivity rate of P-gp function and CD34 + expression in the RR group were significantly higher compared with that in the NT group (P&lt;0.05). In addition, higher CD34 + , P-gp expression  + and P-gp function  + values were observed in older patients compared with younger patients. MDR1 expression was downregulated in certain patients following treatment with AS 2 O 3 . In the present study, the overexpression of P-gp was the primary cause of drug resistance in the AML patients, and MDR1 expression was downregulated by As 2 O 3 in primary leukemia and drug-resistant cells.

Expression of P-gp in acute myeloid leukemia and the reversal function of As2O3 on drug resistance