Drug resistance in leukemia: Remediation by natural means

Leukemia is a common cancer in the paediatric group with good prognosis and the overall survival rate for leukemia has improved over the years. However, despite the chemopreventive agents and better diagnostic and therapeutic strategies, novel strategies and approaches shows better prognosis and overall survival, particularly if detected early. The common modality of haematological malignancy management is chemotherapy. Although good response is noted early on treatment, resistance to the chemotherapy is observed later due to the drug resistance, may be due to increased expression of P-glycoprotein (Pgp) and multidrug resistance protein (MRP1), which may be reversed by inhibitors of the proteins. However, adverse side effects of the chemotherapeutic agents are a cause of concern in several patients. Hence, plant derived molecules (phytochemicals) may be considered as an alternative to the synthetic inhibitors. Phytochemicals possess not only chemopreventive and chemotherapeutic potential, but also can be used for prevention and reversal of drug resistance. Phytochemicals are generally nontoxic, economic and minimal adverse effects are observed. Potential phytochemicals may be used as stand-alone or in combination for cancer treatment.