Resistance to imatinib in patients with chronic myeloid leukemia can lead to advanced disease and blast crisis. Conventional chemotherapy with DNA damaging agents is then used, alone or in combination with other tyrosine kinase inhibitors (TKIs). Our aim was to assess whether imatinib resistant K562 cells were also resistant to DNA damaging agents. After treatment with H 2 O 2 and doxorubicin, but not camptothecin, cell survival was higher in imatinib resistant cells compared to parental cells. DNA damage, measured by comet and g -H2AX assays, was lower in imatinib resistant cells. mRNA expression levels of 50 genes of the DNA damage response pathway showed increased expression of the base excision repair (BER) genes MBD4 and NTHL1 . Knockdown of MBD4 and NTHL1 expression in resistant cells using siRNA decreased cell survival after treatment with H 2 O 2 and doxorubicin. Our results indicate that imatinib resistant cells display cross-resistance to oxidative agents, partly through upregulation of BER genes. Expression of these genes in imatinib resistant patients was not signifi cantly diff erent compared to sensitive patients. However, the strategy followed in this study could help identify chemotherapeutic agents that are more eff ective as alternative agents in cases of resistance to TKIs.
