PMID- 11187893
OWN - NLM
STAT- MEDLINE
DCOM- 20010125
LR  - 20201226
IS  - 0887-6924 (Print)
IS  - 0887-6924 (Linking)
VI  - 14
IP  - 12
DP  - 2000 Dec
TI  - Prognosis of patients with a second relapse of acute myeloid leukemia.
PG  - 2059-63
AB  - 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 < or = 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.
FAU - Stoiser, B
AU  - Stoiser B
AD  - Department of Internal Medicine I, St Anna Children's Hospital, Vienna, Austria.
FAU - Knobl, P
AU  - Knobl P
FAU - Fonatsch, C
AU  - Fonatsch C
FAU - Haas, O A
AU  - Haas OA
FAU - Mitterbauer, G
AU  - Mitterbauer G
FAU - Weltermann, A
AU  - Weltermann A
FAU - Geissler, K
AU  - Geissler K
FAU - Valent, P
AU  - Valent P
FAU - Sperr, W
AU  - Sperr W
FAU - Pabinger, I
AU  - Pabinger I
FAU - Lechner, K
AU  - Lechner K
FAU - Jaeger, U
AU  - Jaeger U
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Leukemia
JT  - Leukemia
JID - 8704895
SB  - IM
MH  - Acute Disease
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Female
MH  - Humans
MH  - Leukemia, Myeloid/drug therapy/*pathology
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Survival Analysis
MH  - Treatment Outcome
EDAT- 2001/02/24 12:00
MHDA- 2001/02/28 10:01
CRDT- 2001/02/24 12:00
PHST- 2001/02/24 12:00 [pubmed]
PHST- 2001/02/28 10:01 [medline]
PHST- 2001/02/24 12:00 [entrez]
AID - 10.1038/sj.leu.2401968 [doi]
PST - ppublish
SO  - Leukemia. 2000 Dec;14(12):2059-63. doi: 10.1038/sj.leu.2401968.