مشخصات پژوهش

Acute myeloid leukemia (AML) is one of the most common and aggressive hematologic malignancies affecting adults worldwide, which is characterized by the clonal proliferation of poorly differentiated myeloid progenitor cells in the bone marrow and peripheral blood. The disease mainly affects older people with about eighty percent of new cases in people aged sixty years and above, and the median age of onset is sixty-nine years . Despite significant advances in therapeutic approaches and supportive care measures over recent decades, long term survival rates for AML patients remain disappointingly low, with five year overall survival rates of approximately twenty nine point five percent according to recent population based data . Among various types of leukemia, AML has the highest mortality rate with an estimated eleven thousand ninety deaths projected in the United States in 2025 . One of the most important challenges in the successful treatment of AML is the emergence of resistance to chemotherapeutic agents, which occurs in a significant proportion of patients and is one of the main reasons for treatment failure and disease relapse . Understanding the molecular mechanisms involved in chemotherapy resistance in AML, therefore, is essential for improving the outcome of patients and developing more effective therapeutic strategies.The phenomenon of multidrug resistance of cancer cells has been extensively studied since its first discovery in 1976 by Juliano and Ling and several mechanisms have been discovered that contribute to this clinical challenge.