A novel prognostic model in elderly patients with acute myeloid leukemia: results of 909 patients entered into the prospective AML96 trial

Abstract

We present an analysis of prognostic factors derived from a trial in patients with acute myeloid leukemia older than 60 years. The AML96 trial included 909 patients with a median age of 67 years (range, 61-87 years). Treatment included cytarabine-based induction therapy followed by 1 consolidation.

Impact of cytogenetics risk on outcome after reduced intensity conditioning allo-SCT from an HLA-identical sibling for patients with AML in first CR: a report from the acute leukemia working party of EBMT

“…11 --13 However, cytogenetics also remain as an independent prognostic factor in older AML patients, and patients belonging to the good-risk group have higher chance of survival but, however, lesser from what is observed in younger patients. 11,13,20 Our study not only confirms the relatively good results of RIC-allo SCT in AML patients in CR1 4,5,17,18 but also provides some data on the potential benefit of RIC allo-SCT according to the cytogenetics, as a 2 --3-year LFS of around 60% is obtained for patients in the intermediate subgroup. Nevertheless, prospective studies are needed to confirm the superiority of RIC allo-SCT compared with non-transplant treatment strategies in AML.…”

FLAGIDA‐lite is an effective regimen for patients between 70 and 80 years with acute myeloid leukemia or refractory anemia with excess blasts‐2 and is feasible as outpatient treatment

“…There was no therapy-related mortality after consolidation chemotherapy. In patients older than 70 years of age with AML or RAEB-2 intensive chemotherapy based on antracycline and cytarabine, as the classic 3 1 7, results in 40%-60% CR but leads to prolonged hospitalization, high IRM (15%-30%), and 2-year OS <10% [2][3][4][5][6][7][8]. Different attempts to improve outcome of intensive chemotherapy have been unsuccessful [24].…”

“…These factors contribute to low complete remission (CR) rates and high induction-related mortality (IRM) when these patients are treated with intensive chemotherapy [4,[6][7][8]. Thus, most physicians consider that older AML patients are unfit for intensive chemotherapy [6][7][8] and research trends point at low-intermediate intensity therapies, including hypomethylating and biologically based agents [9][10][11][12][13][14]. However, several studies suggest that intensive chemotherapy provides better quality of life and longer survival in responders [4,[15][16][17].…”

“…This poor outcome is related to the unfavorable biology of the disease [3,4] as well as to comorbidities or poor performance of the patient [5]. These factors contribute to low complete remission (CR) rates and high induction-related mortality (IRM) when these patients are treated with intensive chemotherapy [4,[6][7][8]. Thus, most physicians consider that older AML patients are unfit for intensive chemotherapy [6][7][8] and research trends point at low-intermediate intensity therapies, including hypomethylating and biologically based agents [9][10][11][12][13][14].…”

Prognostic Factors, Survival Analysis and Cytogenetic Outcomes in Adult Patients with Acute Myeloid Leukemia: A single Center Results

“…In the study performed by Röllig et al which included 909 patients, multivariable cox regression analysis revealed that cytogenetic risk group, presence of NPM1-FLT3 mutation, state of CD34 expression, age, leukocyte count and LDH value were independent risk factors that affect prognosis. 24 Serefhanoglu et al showed that age, ECOG performance status and diagnosis group were the factors that affect complete response and overall survival. 25 In a study performed 26 In the study by Chen et al, 5 independent poor prognostic factors were detected in cox analysis.…”