Sirtuin1 and Chronic Myeloid Leukemia: a Comprehensive Glance at Drug Resistance.

BACKGROUND Chronic myeloid leukemia (CML) is a myeloproliferative disorder, which is caused by BCR-ABL fusion that has tyrosine kinase activity. The emergence of the first generation of tyrosine kinase inhibitors increased survival in patients. CML patients remain in silent phase for a long time by using drugs such as imatinib. Resistance to imatinib causes relapse of disease after using it. Different factors such as mutations, epigenetic factors, and changes in the drug's receptor can play an important role in drug resistance. SIRT1 is an NAD-dependent deacetylase that has a role in regulation of metabolic activities. It has been recently considered as a key regulator of drug resistance in malignancies such as CML. METHODS The resources of this study are from different sites and journals such as ncbi.nlm.nih.gov/pubmed, scopus.com, American Journal of Hematology, International Journal of Hematology, etc. Results: Expression of SIRT1 is increased in patients with imatinib resistance. The mechanism of this resistance is not exactly understood. The inhibition of SIRT1 in CML causes increased sensitivity to imatinib. CONCLUSIONS Recognition of drug resistance factors, reduction or neutralization of them is so important in patients' survival. This study indicates the role of SIRT1 as one of the most common causes of drug resistance in many cancers such as CML.