Objective: To probe into the effects of berberine (BBR) enhance on daunorubicin (DNR)-induced apoptosis of primary acute lymphoblastic leukemia cells (P-ALLCs) in children and the related mechanism. Methods: Bone marrow samples were collected from 12 children newly diagnosed with acute lymphoblastic leukemia (ALL)

mononuclear cells were isolated

2×105/mL living cells was inoculated in the 96-well culture plate containing 20% calf serum 1640. After culture for 4 h

different volumes of PBS were added to dilute DNR and BBR stock solutions according to the single drug and cross-combination application scheme of concentration of 4 DNR and 3 BBR for 24 h of culture intervention. Cell counting kit-8 assay (CCK-8) was used to detect the single drug effects of DNR and BBR and the combination effects on the inhibition of P-ALLCs proliferation. Results: The inhibition rate of DNR was (11.56%±0.73%) to (59.60%±2.80%)

with the increase of DNR concentration

the proliferation inhibition of P-ALLCs increased

and the difference between the latter concentration and the previous concentration was statistically significant (P<0.05). The inhibition rate of BBR was (12.39%±1.50%) to (39.75%±2.43%)

with the increase of BBR concentration

the proliferation inhibition of P-ALLCs increased

and the difference between the latter concentration and the previous concentration was statistically significant (P<0.05). The inhibition rate of DNR combined with BBR was (18.43%±1.11%) to (89.96%±1.40%). In the four combined groups

the proliferation inhibition of P-ALLCs increased with the increase of BBR concentration (P<0.05)

and the inhibition rate of DNR combined with BBR in each group was stronger than that of DNR alone (P<0.05). Conclusion: Both DNR and BBR shows cytotoxic effects and concentration dependence on P-ALLCs in children. BBR can increase the sensitivity of P-ALLCs to DNR

and the effect is related to the concentration.