Therapeutic and Prognostic Factors in the Management of Acute Myeloid Leukemia

Büchner, Thomas; Hiddemann, Wolfgang; Wörmann, Bernhard; Löffler, Helmut; Gaßmann, W.; Haferlach, Torsten; Goasguen, J; Fonatsch, Christa; Becher, R.; Hossfeld, Dieter K.; Lengfelder, Eva; Ludwig, Wolf‐Dieter; Maschmeyer, Georg; Innig, G.; Aul, H C; Heyll, A.; Lathan, B.; Staib, R.; Hellriegel, Klaus-Peter; Fülle, H. H.; Heinecke, Achim; Sauerland, M. C.

doi:10.1007/978-3-642-60377-8_115

Cited by 4 publications

(5 citation statements)

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“…The prognostic impact of age per se is difficult to evaluate in this study as treatment decisions were largely based on age and performance status of the patients, without uniform documentation of the latter. Karyotype has emerged as the most important feature of AML concerning prognosis, and already has therapeutic consequences in modern AML treatment (Bernard et al, 1984;Büchner and Heinecke, 1996;Fenaux et al, 1989;Ferrara et al, 1998). Secondary AML had worse outcome than de novo AML but did not appear as a selected prognostic factor in the present investigation probably due to a strong correlation to the patient age.…”

Section: Discussionmentioning

confidence: 54%

“…Among routinely measured laboratory variables, leucocyte count (Dutcher et al, 1987;Fenaux et al, 1989), LDH (Büchner and Heinecke, 1996;Ferrara and Mirto, 1996) and kidney function tests (Estey et al, 1989;Johnson et al, 1993Johnson et al, , 1995 have repeatedly been assigned prognostic value. Of such variables, LDH and creatinine appeared somewhat stronger than the leucocyte count in the Treatment and outcome of unselected AML 1391 present study, reaching independent significance for survival.…”

Section: Discussionmentioning

confidence: 99%

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Treatment, long-term outcome and prognostic variables in 214 unselected AML patients in Sweden

et al. 2000

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Summary With the aim of describing an unselected series of acute myeloid leukaemias (AML) in adults, patients diagnosed 1987-1992 in the Örebro region of central Sweden were reviewed by investigating hospital records. By utilizing: (1) The Swedish Cancer Registry, (2) The Cause of Death Registry, (3) listings of pathology bone marrow reports and (4) listings of inpatient discharge diagnoses, we attempted to find all patients. Among secondary AML, only blast-crises of CML were excluded. A total of 214 cases of AML with a median age of 69.5 years were verified corresponding to a mean yearly incidence in adults of 5.4/100 000. Of all patients, 56% had received 'high-dose' induction treatment, 28% 'low-dose' treatment and 16% no cytostatic treatment. Median survival for all patients was 5.8 months and the probability of survival at 5 years was 9.3%. The 120 'high-dose' treated patients had a total CR rate of 67%, median CR duration 10.1 months and median survival 11.4 months. Age, LDH and kidney function were found to be independent prognostic variables for survival. The inclusion of patients unreferred from district hospitals makes this study unique as an example of unselected AML.

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Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Treatment, long-term outcome and prognostic variables in 214 unselected AML patients in Sweden

et al. 2000

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“…Cytogenetic abnormalities such as t(8;21), t (15;17), and inv (16) have favorable implications, while del(5), del (7), and chromosome 11 abnormalities are unfavorable. [10][11][12][13] Children's Cancer Group (CCG) Study 213 for children and adolescents with acute myeloid leukemia (AML) was open for patient accrual from January 1986 until February 1989. The goals of this study were to improve both the therapy of pediatric AML and expand our knowledge of the effect of pretreatment characteristics on disease outcome.…”

Section: Introductionmentioning

confidence: 99%

Prognostic variables in newly diagnosed children and adolescents with acute myeloid leukemia: Children's Cancer Group Study 213

et al. 2002

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The objective of this study was to identify biologic parameters that were associated with either exceptionally good or poor outcome in childhood acute myeloid leukemia (AML). Among the children with AML who entered Children's Cancer Group trial 213, 498 patients without Down syndrome or acute promyelocytic leukemia (APL) comprise the basis for this report. Univariate comparisons of the proportion of patients attaining complete remission after induction (CR) indicate that, at diagnosis, male gender, low platelet count (р20 000/ l), hepatomegaly, myelodysplastic syndrome (MDS), French-AmericanBritish (FAB) category M5, high (Ͼ15%) bone marrow (BM) blasts on day 14 of the first course of induction, and +8 are associated with lower CR rates, while abnormal 16 is associated with a higher CR rate. Multivariate analysis suggests high platelet count at diagnosis (Ͼ20 000/ l), absence of hepatomegaly, р15% day 14 BM blast percentage, and abnormal 16 are independent prognostic factors associated with better CR. Univariate analysis demonstrated a significant favorable relationship between platelet count at diagnosis (Ͼ20 000/ l), absence of hepatomegaly, low percentage of BM blasts (р15%), and abnormal 16 with overall survival. Absence of hepatomegaly, р15% day 14 BM blast percentage, and abnormal 16 were determined to be independent prognostic factors associated with better survival. Leukemia (2002) 16, 601-607.

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“…2 In contrast to children and adults, data on biological features and outcome are scarce in the adolescent age group, which represents only a small group, both in pediatric and adult trials. Treatment protocols designed for children and adults often differ in various aspects from each other, and there are no data elucidating which kind of therapy could be particularly appropriate for young adults.…”

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Significance of age in acute myeloid leukemia patients younger than 30 years

Creutzig

Büchner

Sauerland

et al. 2007

Cancer

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BACKGROUND. Data on the impact of age in acute myeloid leukemia (AML) patients <30 years treated in pediatric and adult trials are scarce. METHODS. In all, 891 patients <18 years were treated in the pediatric trials AML‐BFM 93/98 and 290 adolescents and young adults (>16 to <30 years) in the AMLCG 92/99 and AMLSG HD93/98A trials. Treatment schedules and dose intensities were comparable. RESULTS. Initial features and risk factors differed considerably between infants (<2 years) and older age groups and only slightly between children (2 to <13), adolescents (13 to <21) and young adults (21 to <30). Treatment results were most favorable in children (5‐year event free survival [EFS]: 54% ± 3%), slightly inferior in adolescents (46% ± 4%, P = .03), and unfavorable in young adults (28% ± 5%, P = .0001). Excluding patients with favorable karyotypes, the results were similar in infants and children (EFS: 44% ± 4% and 46% ± 3%, respectively) and inferior in adolescents (35% ± 4%) and young adults (23% ± 4%). There was an increased, age‐related percentage and inferior outcome in patients with >5% bone marrow blasts after induction. EFS was especially poor in young adults, with blasts >5%. The blast count after induction was of no prognostic value in patients with favorable karyotypes, but a significant risk factor in patients with other cytogenetics. CONCLUSIONS. Biologic data differed mainly between infants and older age groups. When comparing the same age groups, outcome was similar between the trial groups, which differed from reports concerning acute lymphoblastic leukemia. However, the prognosis decreased after childhood independent of other risk factors. This indicates that even in the younger cohorts increasing age may be an additional unfavorable factor. Cancer 2008. © 2007 American Cancer Society.

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Therapeutic and Prognostic Factors in the Management of Acute Myeloid Leukemia

Cited by 4 publications

References 13 publications

Treatment, long-term outcome and prognostic variables in 214 unselected AML patients in Sweden

Treatment, long-term outcome and prognostic variables in 214 unselected AML patients in Sweden

Prognostic variables in newly diagnosed children and adolescents with acute myeloid leukemia: Children's Cancer Group Study 213

Significance of age in acute myeloid leukemia patients younger than 30 years

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