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Treatment of Acute Myeloid Leukemia in Patients Upper the Age of 60 Years Report of the AML97-38 Study of the East German Hematology and Oncology Study Group



Treatment of Acute Myeloid Leukemia in Patients Upper the Age of 60 Years Report of the AML97-38 Study of the East German Hematology and Oncology Study Group



Blood 100(11): Abstract No 1337, November 16



Treatment of elderly patients with AML still remains a very sensitive balance act between efficacy and toxicity of chemotherapy. In the AML 97 study of the OSHO a curative induction and consolidation protocol was tested in patients with AML over the age of 60 a. Induction therapy consisted of one or two cycles of AraC 2 g/m2 iv on days 1,3,5,7 and mitoxantrone 10 mg/m2 iv day 1-3. Patients entering complete remission were treated with 2 consolidation courses (240 mg/m2 AraC day 1-5, 10 mg/m2 mitoxantrone day 1+2). Since March 1998, 187 patients entered the protocol, 117 patients (median age 65a; 60-80) with de novo AML and 70 patients (median age 68a; 60-79) with secondary AML. CR was obtained in 86 (73,5%, 95%CI:64,4-80,9) patients with de novo and in 41 (58,6%, 95%CI:46,2-70,2) patients with secondary AML with an early death rate of 12% and 18,6%, respectively. Furthermore, with a median follow-up of 9 (range 1-44) months the OS at 2 years was 33+-5% for patients with de novo and 22+-8% for secondary AML. Cytogenetics were the best predictor for survival We conclude, that a high proportion of elderly patients with AML reach CR with acceptable early death rate. To reduce relapse rate, a phase II study using related HCT after 2 Gy TBI/Fludarabine in combination with cyclosporine and mycophenolate mofetil was initiated by the OSHO/FHCRC/HOVON/SAKK and FRENCH Study Groups.

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