A New Histology-based Prognostic Index for Acute Myeloid leukemia: Preliminary results for the "AML Urayasu Classification "

Background: To elucidate the mechanisms of resistance to treatment in patients with acute myeloid leukemia (AML) except for M3 so as to devise ways to overcome them and improve the treatment outcomes. Methods: For this study, we randomly selected 35 patients with AML who had received combined cytarabine plus idarubicin treatment for new-onset AML at our hospital. Expressions of 23 treatment-resistance-related proteins in the biopsy specimens were evaluated by immunohistochemical staining using the corresponding antibodies, followed by retrospective analysis of the correlations between the expression　of the resistance proteins and patient survival. Results: The following four proteins were identified as being particularly significant in relation to treatment resistance and patient prognosis. 1) p53, 2) Multidrug resistance-associated protein 1 (MRP1) (Idarubicin extracellular efflux pump) 3)Aldo-keto reductase family 1 member B10 (AKR1B10) (Idarubicin-inactivating enzyme), and 4)AKR1B1 (AKR1B10 competitive