Chemotherapeutic drug sensitivity testing of human leukemia cells in vitro using a semiautomated fluorometric assay.

A simple and reproducible semiautomated fluorometric method for drug sensitivity testing of leukemic cells in microculture is described. The assay is based on hydrolysis of nonfluorescent fluorescein diacetate (FDA) to a strongly fluorescent product (fluorescein) by cells with intact plasma membranes after 72 hr of culture and was in the present study applied to acute lymphocytic leukemia (ALL) cell lines and specimens from patients with lymphocytic and myelocytic leukemia. FDA fluorescence was linearly related to viable cell number within a wide range of cell densities (3-4 logs) as well as in the presence of different added proportions of dead cells. The assay reliably detects high and low grade resistance to vincristine (vcr) and daunorubicin, respectively, as well as the subsequent reversal of vcr resistance by cyclosporin A and the calcium channel blocker verapamil. Using ALL cell lines, drug sensitivity was in good correspondence with data obtained by the microculture tetrazolium assay. Furthermore, drug sensitivity data of fresh leukemia cells from patients with leukemia were readily obtained. The results indicate that the presently described method is applicable for simple and reliable chemosensitivity testing of leukemia cell lines as well as tumor specimens from patients with leukemia.