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World J Exp Med. May 20, 2013; 3(2): 21-25
Published online May 20, 2013. doi: 10.5493/wjem.v3.i2.21
Steroid resistance in leukemia
Darshan S Shah, Raj Kumar
Darshan S Shah, Raj Kumar, Department of Basic Sciences, The Commonwealth Medical College, Scranton, PA 18509, United States
Author contributions: Both authors contributed to this paper.
Correspondence to: Raj Kumar, PhD, Department of Basic Sciences, The Commonwealth Medical College, Scranton, 525 Pine Street, Scranton, PA 18509, United States. rkumar@tcmedc.org
Telephone: +1-570-5049675 Fax: +1-570-5049660
Received: April 10, 2013
Revised: May 2, 2013
Accepted: May 19, 2013
Published online: May 20, 2013
Abstract

There are several types of leukemia which are characterized by the abnormal growth of cells from the myeloid or lymphoid lineage. Because of their lympholytic actions, glucocorticoids (GCs) are included in many therapeutic regimens for the treatment of various forms of leukemia. Although a significant number of acute lymphoblastic leukemia patients respond well to GC treatment during initial phases; prolonged treatments sometimes results in steroid-resistance. The exact mechanism of this resistance has yet not been completely elucidated, but a correlation between functional GC receptor expression levels and steroid-resistance in patients has been found. In recent years, several other mechanisms of action have been reported that could play an important role in the development of such drug resistances in leukemia. Therefore, a better understanding of how leukemic patients develop drug resistance should result in drugs designed appropriately to treat these patients.

Keywords: Leukemia, Glucocorticoid, Steroid resistant, Mutations, Genes

Core tip: The exact mechanism of this resistance has yet not been completely elucidated, but a correlation between functional glucocorticoid receptor expression levels and steroid-resistance in patients has been found. In recent years, several other mechanisms of action have been reported that could play an important role in the development of such drug resistances in leukemia.