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Prognosis in AML

Prognosis of patients with a second relapse of acute myeloid leukemia

Leukemia volume 14, pages 2059–2063 (2000)Cite this article

Abstract

Recurrence of the disease is the major problem in the treatment of acute myeloid leukemia (AML). The majority of patients who achieve a second remission will ultimately relapse. In this retrospective single-center study, we have analyzed the outcome of patients with a second relapse and tried to define the prognostic factors in intensively treated patients. Of 534 patients with AML, 62 had a second relapse. Thirty-three received further intensive chemotherapy (CT). Eighteen patients (55%) achieved a third complete remission (CR). The early death (ED) rate was only 9%. The overall survival (OS) of treated vs untreated patients was 6.9 vs 1.3 months, respectively (P = 0.01). the major selection criteria for a third ct were a favourable (t(15;17),t(8;21),inv(16)) or normal karyotype, long (>11 months) second CR (P ⩽ 0.005) and no previous bone marrow transplantation (BMT)(P < 0.01). favorable or normal karyotype, second cr >11 months, as well as no previous BMT (P < 0.01) were associated with the achievement of a third CR. Favorable (P < 0.005) or normal karyotype (P < 0.01), as well as a second cr >11 months (P < 0.005) were associated with prolonged survival after ct. the median os for patients receiving ct with favorable or normal cytogenetics, a second cr > 11 months, but no previous BMT was 26.5 months. Five patients with favorable or normal karyotype achieved a fourth or fifth remission. We conclude that intensive CT is associated with a survival benefit and good quality of life if patients are properly selected.

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Acknowledgements

We thank S Hagman and U Zeman for their excellent technical and administrative assistance. This work was supported by grants from the Anton Dreher Stiftung and the Komission Onkologie of the Medical Faculty of the University of Vienna.

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Authors and Affiliations

  1. Department of Internal Medicine I (Division of Hematology and Hemostaseology), St Anna Children's Hospital, Vienna, Austria

    B Stoiser, P Knöbl, A Weltermann, K Geissler, P Valent, W Sperr, I Pabinger, K Lechner & U Jaeger

  2. Institute of Medical Biology, St Anna Children's Hospital, Vienna, Austria

    C Fonatsch

  3. Children's Cancer Research Institute, St Anna Children's Hospital, Vienna, Austria

    OA Haas

  4. Institute of Laboratory Medicine, Molecular Biology, University of Vienna, Austria

    G Mitterbauer

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Stoiser, B., Knöbl, P., Fonatsch, C. et al. Prognosis of patients with a second relapse of acute myeloid leukemia. Leukemia 14, 2059–2063 (2000). https://doi.org/10.1038/sj.leu.2401968

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