We established a novel human
acute lymphoblastic leukemia cell line made resistant to two
folate analogues,
trimetrexate (TMQ) and N10-propargyl-5,8-dideazafolic
acid (
CB3717), by sequential exposure of the 200-fold TMQ-resistant cells (MOLT-3/TMQ200) to
CB3717. A 30-fold-resistant subline to
CB3717 was selected from the TMQ-resistant cells and designated as MOLT-3/TMQ200-CB371730. This double-
folate-resistant cell line was 15-fold more resistant to
methotrexate (MTX) than MOLT-3/TMQ200; however, TMQ resistance was decreased to 10-fold as compared to MOLT-3/TMQ200. The doubly resistant cells also showed 2-fold cross-resistance to
5-fluorouracil (5-FU). Equimolar concentrations of
leucovorin almost completely reversed the inhibitory effect of MTX on the doubly resistant cells and partially that of
CB3717 and TMQ; on the other hand,
leucovorin enhanced the inhibitory effect of
5-FU.
Thymidylate synthase activities demonstrated little or no difference among these three cell lines, being consistent with no overexpression of
mRNA for this
enzyme in the doubly resistant cells. MOLT-3/TMQ200 cells displayed classical multidrug resistance; sequential development of
CB3717 resistance in the TMQ-resistant cells resulted in an enhancement of the multidrug-resistance phenotype and a concomitant increase of MDR1
mRNA. The development of a complex resistance pattern seen in this double-
folate-resistant subline indicates intricacy in the study of drug resistance after multidrug
chemotherapy.