We evaluated the predictive value of mdr1 mRNA RT-PCR, P-glycoprotein (Pgp), and Daunorubicin efflux assays as regards achieving complete remission (CR), overall survival (OS), and leukemia-free survival (LFS) in 72 patients with AML. mdr1 mRNA, Pgp, and Efflux were expressed in 55.6%, 36.1%, and 33.3%. Efflux+ was associated with a lower CR rate (P = 0.006). A multivariate analysis of OS identified 3 prognostic factors: WBC (P = 0.028), age (P = 0.002), and Efflux (P = 0.005), while those of LFS identified 2 prognostic factors: age (P = 0.021) and Efflux (P < 0.001). Efflux was the most reliable method in predicting an achievement of CR and stratifying the patients according to the prognosis in terms of OS and LFS in AML.
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