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Long-term follow-up of the AML97 study for patients aged 60 years and above with acute myeloid leukaemia: a study of the East German Haematology and Oncology Study Group (OSHO)

  • Original Article – Clinical Oncology
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Abstract

Introduction

Treatment of patients (pts) with acute myelogenous leukaemia (AML) above 60 years remains a challenge. We report long-term follow-up of the AML97 study, where pts were registered at diagnosis and received treatment dependent on their comorbidities: dose-intense cytarabine (AraC) and anthracycline in the curative arm, and low-dose chemotherapy in the palliative arm or best supportive care.

Materials and Methods

A total of 618 pts were enrolled in this protocol (curative 471, palliative 115 and supportive 32). In the curative arm, complete remission (CR) was obtained in 66.8 % of pts and the estimated probability of being alive at 2 years was 0.30 (±0.02 SE). In multivariate analysis, gender (p = 0.005), performance status (p = 0.04) and cytogenetics (p = 0.002) were significant factors for CR. With a median follow-up of 10 (range 0.1–11.8) years, the estimated probability of being event-free after 2 and 5 years according to cytogenetics was 0.48 ± 0.11 and 0.48 ± 0.11 for favourable, 0.20 ± 0.03 and 0.09 ± 0.03 for normal, 0.18 ± 0.06 and 0.10 ± 0.05 for other standard risk and 0.10 ± 0.03 and 0.05 ± 0.02 for unfavourable karyotypes, respectively. The median survival time for pts treated with palliative chemotherapy was 54 and 11 days with best supportive care only.

Conclusion

In conclusion, treatment of older AML pts with dose-intense AraC is feasible in the majority of pts and induces high rates of CR. Nevertheless, except for favourable karyotype, OS and event-free survival remain low. These results need to be viewed in relation to the new modalities including stem cell transplantation following non-myeloablative conditioning, epigenetic and molecular therapies.

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Authors and Affiliations

  1. Department of Haematology and Oncology, Klinikum Magdeburg gGmbH, Birkenallee 34, 39130, Magdeburg, Germany

    C. Kahl & E. Kettner

  2. Department of Haematology and Oncology, Palliative Medicine, University of Rostock, Rostock, Germany

    C. Kahl & C. Junghanß

  3. Department of Haematology, Clinical Oncology, University Hospital of Leipzig, Leipzig, Germany

    R. Krahl, C. Becker, H. K. Al-Ali & D. Niederwieser

  4. Department of Haematology and Oncology, Helios Kliniken Erfurt, Erfurt, Germany

    H. G. Sayer, A. Schulze & M. Herold

  5. Department of Hematology/Oncology, Jena University Hospital, Jena, Germany

    H. G. Sayer, S. Scholl & A. Hochhaus

  6. Clinic of Internal Medicine III, Klinikum Chemnitz gGmbH, Chemnitz, Germany

    M. Hänel

  7. Department of Haematology and Oncology, Charité - Campus Virchow-Klinikum, Berlin, Germany

    L. Uharek

  8. Department of Haematology and Oncology, Palliative Care, Ernst von Bergmann Hospital, Potsdam, Germany

    G. Maschmeyer

  9. Department of Haematology and Oncology, Klinikum Schwerin, Schwerin, Germany

    D. Haehling

  10. Department of Internal Medicine II, Klinikum Cottbus, Cottbus, Germany

    N. Peter

  11. Praxis für Hämatologie und Onkologie, Lüdenscheid, Germany

    D. Kämpfe

  12. Department of Haematology and Oncology, University of Magdeburg, Magdeburg, Germany

    T. Heinicke & T. Fischer

  13. Department of Haematology and Oncology, Palliative Care, Heinrich-Braun-Hospital, Zwickau, Germany

    U. Kreibich

  14. Department of Haematology and Oncology, University Hospital Halle, Halle, Germany

    H.-H. Wolf

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  1. C. Kahl
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  2. R. Krahl
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  3. C. Becker
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  4. H. K. Al-Ali
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  5. H. G. Sayer
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  6. A. Schulze
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  7. M. Herold
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  8. M. Hänel
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  11. L. Uharek
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  12. G. Maschmeyer
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  14. C. Junghanß
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  15. N. Peter
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  16. D. Kämpfe
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  17. E. Kettner
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  18. T. Heinicke
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  19. T. Fischer
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  20. U. Kreibich
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  21. H.-H. Wolf
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  22. D. Niederwieser
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Correspondence to C. Kahl.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Kahl, C., Krahl, R., Becker, C. et al. Long-term follow-up of the AML97 study for patients aged 60 years and above with acute myeloid leukaemia: a study of the East German Haematology and Oncology Study Group (OSHO). J Cancer Res Clin Oncol 142, 305–315 (2016). https://doi.org/10.1007/s00432-015-2045-8

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