title: 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).
abstract: BACKGROUND
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Haematology and Oncology, Klinikum Magdeburg gGmbH, Birkenallee 34, 39130, Magdeburg, Germany. christoph.kahl@klinikum-magdeburg.de.|Department of Haematology and Oncology, Palliative Medicine, University of Rostock, Rostock, Germany. christoph.kahl@klinikum-magdeburg.de.
authors.forename: C
authors.initials: C
authors.lastname: Kahl
authors.affiliation: Department of Haematology, Clinical Oncology, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Krahl
authors.affiliation: Department of Haematology, Clinical Oncology, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Becker
authors.affiliation: Department of Haematology, Clinical Oncology, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: H K
authors.initials: HK
authors.lastname: Al-Ali
authors.affiliation: Department of Haematology and Oncology, Helios Kliniken Erfurt, Erfurt, Germany.|Department of Hematology/Oncology, Jena University Hospital, Jena, Germany.
authors.forename: H G
authors.initials: HG
authors.lastname: Sayer
authors.affiliation: Department of Haematology and Oncology, Helios Kliniken Erfurt, Erfurt, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Schulze
authors.affiliation: Department of Haematology and Oncology, Helios Kliniken Erfurt, Erfurt, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Herold
authors.affiliation: Clinic of Internal Medicine III, Klinikum Chemnitz gGmbH, Chemnitz, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Hänel
authors.affiliation: Department of Hematology/Oncology, Jena University Hospital, Jena, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Scholl
authors.affiliation: Department of Hematology/Oncology, Jena University Hospital, Jena, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Hochhaus
authors.affiliation: Department of Haematology and Oncology, Charité - Campus Virchow-Klinikum, Berlin, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Uharek
authors.affiliation: Department of Haematology and Oncology, Palliative Care, Ernst von Bergmann Hospital, Potsdam, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Maschmeyer
authors.affiliation: Department of Haematology and Oncology, Klinikum Schwerin, Schwerin, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Haehling
authors.affiliation: Department of Haematology and Oncology, Palliative Medicine, University of Rostock, Rostock, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Junghanß
authors.affiliation: Department of Internal Medicine II, Klinikum Cottbus, Cottbus, Germany.
authors.forename: N
authors.initials: N
authors.lastname: Peter
authors.affiliation: Praxis für Hämatologie und Onkologie, Lüdenscheid, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Kämpfe
authors.affiliation: Department of Haematology and Oncology, Klinikum Magdeburg gGmbH, Birkenallee 34, 39130, Magdeburg, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Kettner
authors.affiliation: Department of Haematology and Oncology, University of Magdeburg, Magdeburg, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Heinicke
authors.affiliation: Department of Haematology and Oncology, University of Magdeburg, Magdeburg, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Fischer
authors.affiliation: Department of Haematology and Oncology, Palliative Care, Heinrich-Braun-Hospital, Zwickau, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Kreibich
authors.affiliation: Department of Haematology and Oncology, University Hospital Halle, Halle, Germany.
authors.forename: H-H
authors.initials: HH
authors.lastname: Wolf
authors.affiliation: Department of Haematology, Clinical Oncology, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Niederwieser
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D011379:Prognosis; D012074:Remission Induction; D015996:Survival Rate; D013997:Time Factors
keywords: AML; Elderly; Long-term follow-up; Therapy