Using cyclosporin A (CsA) to inhibit P-glycoprotein (P-gp) funcoxidative phosphorylation, such as cyanide and azide, thereby tion we showed previously that there was a discordance depleting cellular ATP and inhibiting all energy-dependent between the ability of acute myeloid leukemic (AML) blast cells processes. This strategy was used originally to demonstrate the to accumulate daunorubicin and P-gp antigen expression (Xie ATP dependence of P-gp, 7 and more recently has been shown et al, Leukemia 1995; 9: 1882-1887). This discordance suggests to inhibit drug efflux via MRP. 8,9 We now report that it also that a CsA-sensitive drug efflux mechanism distinct from P-gp is expressed in many clinical samples. In the present study appears to show the presence of high levels of non-P-gp The following human cell lines were used to study energy- AML lines OCI/AML 1-5, established in this Institute. In