Mechanisms of Acquired ARA-C and DAC Resistance in Acute Myeloid Leukemia (AML): Development of a Model for the Study of Mutational Loss of Deoxycytidine Kinase (DCK) Activity

Complex and largely unknown mechanisms determine whether sufficient cyto-reduction occurs following chemotherapy for acute myeloid leukemia. The reasons for failure of induction treatment are related to patients’ age. With the current supportive care measures, it is uncommon for patients 60 years the cause of the failure rate (50%), can be equally divided between resistant leukemia and death occuring during marrow aplasia, due to the complications of pancytopenia. However, during subsequent relapses the majority of patients fails to respond due to drug resistance, and this is one of the major obstacles for long term disease free survival [1–3].