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| Clinical observation of Weicanqing Granule reversed multidrug resistance in relapse/refractory acute myeloid leukemia (non-acute promyelocytic leukemia) |
| Hits 643 Download times 765 Received:December 10, 2022 |
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| DOI
10.11656/j.issn.1672-1519.2023.03.01 |
| Key Words
Weicanqing Granule|recurrent/refractory acute myeloid leukemia|MDR1|P-gp|cell cycle |
| Author Name | Affiliation | E-mail | | YAN Lixiang | Department of Hematology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China
National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China | | | JIANG Jing | Department of DigestiveⅡ, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin 300120, China | | | YANG Xiangdong | Department of Hematology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China
National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China | | | HE Jin | Department of Hematology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China
National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China | | | YANG Xi | Department of Hematology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China
National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China | | | CHEN Haijing | Department of Hematology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China
National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China | | | LI Deguan | Institute of Radiation Medicine Chinese Academy of Medical Sciences, Tianjin 300193, China | | | SHI Zhexin | Department of Hematology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China
National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China | shzhx0604@163.com |
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| Abstract
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| [Objective] To observe the effect and mechanism of Weicanqing Granules in reversing drug resistance in relapsed/refractory acute myeloid leukemia (R/R AML).[Methods] The 72 patients with R/R AML were randomly divided into treatment group (39 cases,Weicanqing Granules combined with conventional chemotherapy) and control group (33 cases,conventional chemotherapy alone). Blood routine proportion of bone marrow primordial cells,minimal residual disease (MRD),WT1,bone marrow remission rate,overall survival rate (OS),remission time(RT) and adverse reactions. Bone marrow cell MRD1,P-gp and cell cycle were detected by reverse transcription-polymerase chain reaction(RT-PCR) and flow cytometry before and after treatment.[Results] After treatment,the proportion of bone marrow primitive cells (primitive+immature) and the count of peripheral blood leukocytes in the two groups were significantly improved (P<0.05);After treatment,compared with the control group,the peripheral hemogram and the proportion of bone marrow primitive cells in the treatment group were significantly improved (P<0.05). After treatment,the levels of MRD and WT1 in the two groups were lower than those before treatment,but the levels of MRD and WT1 in the treatment group were significantly lower than those in the control group (P<0.05). After treatment,the bone marrow remission rate in the treatment group (61.54%) was significantly higher than that in the control group (36.36%,P<0.05). The 12-months overall survival rate in the treatment group (69.23%) was higher than that in the control group (45.45%,P<0.05),but there was no difference in the 24-months overall survival rate between the treatment group (40.05%) and the control group (27.27%,P<0.05). In the control group,12 patients had bone marrow remission,the longest remission time was 21 months, the shortest remission time was 5 months,the median remission time was 8.5 months,and the average remission time was 9.83 months. In the treatment group,24 patients were in remission. The longest remission time was 21 months,the shortest remission time was 2 months,the median remission time was 14 months,and the average remission time was 13.63 months. There was significant difference in mean remission time between the two groups (P<0.05). After treatment,the ratio of P-gp in the treatment group was lower than that in the control group (P<0.05),while the expression of MDR1 in the control group increased,and the expression of MDR1 in the treatment group decreased significantly (P<0.05). After treatment,the proportion of S phase and G2/M phase of bone marrow cell cycle in the treatment group increased,and the proportion of G0 phase decreased,which was significantly different from that before treatment and in the control group (P<0.05). Both groups had bone marrow suppression,gastrointestinal reaction,liver and kidney dysfunction,hair loss and other adverse reactions,which improved after symptomatic treatment. There was no significant difference in the incidence of adverse reactions between the two groups.[Conclusion] The combination of Weicanqing Granules and chemotherapy can improve the clinical efficacy of R/R AML patients. The mechanism may be related to the decrease of the expression of MDR1 encoded P-gp protein and the induction of leukemic cells into the cell cycle,so as to improve the sensitivity of chemotherapy drugs. |
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