Abstract
In order to evaluate dexverapamil as a resistance modifier in acute myeloid leukaemia, we have added dexverapamil (4×300 mg/d orally) to DA chemotherapy (daunorubicin, cytosine arabinoside) in six patients with acute myeloid leukaemia. Two patients (1 first and 1 second relapse) achieved complete remission and two patients (1 refractory disease, 1 third relapse) showed some improvement. One patient in first relapse died due to disease progression and one drug-refractory patient remained refractory. The peak plasma levels of dexverapamil and nordexverapamil ranged from about 600 to 4100 ng/ml and from 450 to 1130 ng/ml, respectively. Major sideeffects were hypotension and sinus bradycardia. These results show the need for further evaluation of dexverapamil as a resistance modifier in acute myeloid leukaemia.
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References
Campos L, Guyotat D, Archimbaud E, Calmard-Oriol P, Tsuruo T, Troncy J, Treille D, Fiere D (1992) Clinical significance of multidrug resistance P-glycoprotein expression on acute nonlymphoblastic leukemia cells at diagnosis. Blood 79: 473–476
Harapat SR, Kates RE (1980) High-performance liquid chromatographic analysis of verapamil. J Chromatogr 181: 484–489
Marie PJ, Zittoun R, Sikic BI (1991) Multidrug resistance (mdr1) gene expression in adult leukemias: correlations with treatment outcome and in vitro drug sensitivity. Blood 78: 586–592
Pastan I, Gottesman MM (1987) Multiple-drug resistance in human cancer. N Engl J Med 316: 1388–1393
Pirker R, FitzGerald DJP, Raschack M, Zimmermann F, Willingham MC, Pastan I (1989) Enhancement of the activity of immunotoxins by analogues of verapamil. Cancer Res 49: 4791–4795
Pirker R, Keilhauer G, Raschack M, Lechner C, Ludwig H (1990) Reversal of multidrug resistance in human KB cell lines by structural analogs of verapamil. Int J Cancer 45: 916–919
Pirker R, Wallner J, Geissler K, Linkesch W, Hass OA, Bettelheim P, Hopfner M, Scherrer R, Valent P, Havelec L, Ludwig H, Lechner K (1991) MDR1 gene expression and treatment outcome in acute myeloid leukemia. J Natl Cancer Inst 83: 708–712
Pirker R, Wallner J, Gsur A, Götzl M, Zöchbauer S, Scheithauer W, Depisch D (1993) MDR1 gene expression in primary colorectal carcinomas. Br J Cancer 68: 691–694
Sato H, Preisler H, Day R, Raza A, Larson R, Browman G, Goldberg J Vogler R, Grunwald H, Gottlieb A, Bennett J, Gottesman M, Pastan I (1993) MDR1 transcript levels as an indication of resistant disease in acute myelogenous leukemia. Br J Haematol 75: 340–345
Sonneveld P, Nooter K (1990) Reversal of drug-resistance by cyclosporin-A in a patient with acute myelocytic leukaemia. Br J Haematol 75: 208–211
Wallner J, Depisch D, Hopfner M, Haider K, Spona J, Ludwig H, Pirker R (1991) MDR1 gene expression and prognostic factors in primary breast carcinomas. Eur J Cancer 27: 1352–1355
Wiernik PH (1989) Acute leukemias. In: De Vita VT Jr, Hellman S, Rosenberg SA (eds) Cancer: principles and practice of oncology. Lippincott, Philadelphia
Zöchbauer S, Gsur A, Brunner R, Kyrle A, Lechner K, Pirker R (1994) P-glycoprotein expression as unfavorable prognostic factor in acute myeloid leukemia. Leukemia 8: 974–977
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Pirker, R., Zöchbauer, S., Kupper, H. et al. Dexverapamil as resistance modifier in acute myeloid leukaemia. J Cancer Res Clin Oncol 121 (Suppl 3), R21–R24 (1995). https://doi.org/10.1007/BF02351067
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DOI: https://doi.org/10.1007/BF02351067