Treatment Results In Acute Myeloid Leukemia Over a Time Period Of 20 Years: Analysis Of The German-Austrian Acute Myeloid Leukemia Study Group (AMLSG)

• Published in: Blood 2013-11, Vol.122 (21), p.3878-3878
• Main Authors: Schlenk, Richard F., Döhner, Konstanze, Heuser, Michael, Späth, Daniela, Morlok, Carina, Lamparter, Alexander, Koehne, Klaus-Henning, Horst, Heinz-August, Brossart, Peter, Held, Gerhard, Kündgen, Andrea, Ringhoffer, Mark, Wattad, Mohammed, Salih, Helmut R., Goetze, Katharina S., Wulf, Gerald, Theobald, Matthias, Rummel, Mathias J., Fiedler, Walter, Westermann, Jörg, Salwender, Hans, Petzer, Andreas L., Hartmann, Frank, Lübbert, Michael, Martens, Uwe M., Greil, Richard, Kirchner, Hartmut, Paschka, Peter, Gaidzik, Verena I., Kayser, Sabine, Teleanu, Veronica, Thol, Felicitas, Göhring, Gudrun, Ganser, Arnold, Döhner, Hartmut
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V122.21.3878.3878

▪ Overall survival (OS) in acute myeloid leukemia (AML) treated with intensive chemotherapy has improved over the last 20 year especially in younger adults (18-60 years) but still remains poor in older patients (>60 years) (Döhner et al. Blood 2010). The German-Austrian AMLSG performed controlled prospective treatment trials since 1993 starting with a risk-adapted approach (phase I, 1993-1997), followed by randomized and risk-adapted treatment strategies based on cytogenetic risk groups (phase II, 1997-2002); since 2003 addition of differentiating agents and HiDAC inhibitors to intensive induction therapy was evaluated (phase III, 2003-2007). Of note, until 2007 younger and older patients (> 60 years) were treated in separate protocols with significantly lower dosages of chemotherapy in older patients. Starting from 2008, risk-adapted therapies were replaced successively by a genotype-adapted approach and the artificial age cut-off at 60 years was abandoned (phase IV, 2008-2012). To evaluate the outcome of adult AML patients within the different time periods. The study included 4705 intensively treated adults (younger, n=3546; older, n=1159) with newly diagnosed AML enrolled on 11 AMLSG treatment trials between 1993 and 2012. Patients with acute promyelocytic leukemia were excluded. All patients received intensive induction and consolidation therapy. Analyzed outcome variables were first complete remission rates (CR1), relapse-free survival (RFS), survival after relapse (SAR) and OS. Analyses were performed according to age groups (18-60 vs. >60 yrs). In younger patients comparisons were performed for the 4 treatment phases (I-IV), whereas for older patients analyses were restricted to phase II-IV. In younger patients CR rates did not improve over time (1993-2013) and varied between 72% and 77% (p=0.12), whereas early and hypoplastic (ED/HD) death rates significantly declined from 10% to 5% (p=0.0001). In older patients CR rates significantly improved over time from 44% to 50% between 1998 and 2007 to 67% after 2008 (p