PMID- 21131036 OWN - NLM STAT- MEDLINE DCOM- 20101228 LR - 20220411 IS - 1474-547X (Electronic) IS - 0140-6736 (Linking) VI - 376 IP - 9757 DP - 2010 Dec 11 TI - Complete remission and early death after intensive chemotherapy in patients aged 60 years or older with acute myeloid leukaemia: a web-based application for prediction of outcomes. PG - 2000-8 LID - 10.1016/S0140-6736(10)62105-8 [doi] AB - BACKGROUND: About 50% of patients (age >/=60 years) who have acute myeloid leukaemia and are otherwise medically healthy (ie, able to undergo intensive chemotherapy) achieve a complete remission (CR) after intensive chemotherapy, but with a substantially increased risk of early death (ED) compared with younger patients. We verified the association of standard clinical and laboratory variables with CR and ED and developed a web-based application for risk assessment of intensive chemotherapy in these patients. METHODS: Multivariate regression analysis was used to develop risk scores with or without knowledge of the cytogenetic and molecular risk profiles for a cohort of 1406 patients (aged >/=60 years) with acute myeloid leukaemia, but otherwise medically healthy, who were treated with two courses of intensive induction chemotherapy (tioguanine, standard-dose cytarabine, and daunorubicin followed by high-dose cytarabine and mitoxantrone; or with high-dose cytarabine and mitoxantrone in the first and second induction courses) in the German Acute Myeloid Leukaemia Cooperative Group 1999 study. Risk prediction was validated in an independent cohort of 801 patients (aged >60 years) with acute myeloid leukaemia who were given two courses of cytarabine and daunorubicin in the Acute Myeloid Leukaemia 1996 study. FINDINGS: Body temperature, age, de-novo leukaemia versus leukaemia secondary to cytotoxic treatment or an antecedent haematological disease, haemoglobin, platelet count, fibrinogen, and serum concentration of lactate dehydrogenase were significantly associated with CR or ED. The probability of CR with knowledge of cytogenetic and molecular risk (score 1) was from 12% to 91%, and without knowledge (score 2) from 21% to 80%. The predicted risk of ED was from 6% to 69% for score 1 and from 7% to 63% for score 2. The predictive power of the risk scores was confirmed in the independent patient cohort (CR score 1, from 10% to 91%; CR score 2, from 16% to 80%; ED score 1, from 6% to 69%; and ED score 2, from 7% to 61%). INTERPRETATION: The scores for acute myeloid leukaemia can be used to predict the probability of CR and the risk of ED in older patients with acute myeloid leukaemia, but otherwise medically healthy, for whom intensive induction chemotherapy is planned. This information can help physicians with difficult decisions for treatment of these patients. FUNDING: Deutsche Krebshilfe and Deutsche Forschungsgemeinschaft. CI - Copyright (c) 2010 Elsevier Ltd. All rights reserved. FAU - Krug, Utz AU - Krug U AD - Department of Medicine A, Haematology and Oncology, University of Munster, Munster, Germany. utz.krug@ukmuenster.de FAU - Rollig, Christoph AU - Rollig C FAU - Koschmieder, Anja AU - Koschmieder A FAU - Heinecke, Achim AU - Heinecke A FAU - Sauerland, Maria Cristina AU - Sauerland MC FAU - Schaich, Markus AU - Schaich M FAU - Thiede, Christian AU - Thiede C FAU - Kramer, Michael AU - Kramer M FAU - Braess, Jan AU - Braess J FAU - Spiekermann, Karsten AU - Spiekermann K FAU - Haferlach, Torsten AU - Haferlach T FAU - Haferlach, Claudia AU - Haferlach C FAU - Koschmieder, Steffen AU - Koschmieder S FAU - Rohde, Christian AU - Rohde C FAU - Serve, Hubert AU - Serve H FAU - Wormann, Bernhard AU - Wormann B FAU - Hiddemann, Wolfgang AU - Hiddemann W FAU - Ehninger, Gerhard AU - Ehninger G FAU - Berdel, Wolfgang E AU - Berdel WE FAU - Buchner, Thomas AU - Buchner T FAU - Muller-Tidow, Carsten AU - Muller-Tidow C CN - German Acute Myeloid Leukaemia Cooperative Group CN - Study Alliance Leukemia Investigators LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20101203 PL - England TA - Lancet JT - Lancet (London, England) JID - 2985213R RN - 04079A1RDZ (Cytarabine) RN - BZ114NVM5P (Mitoxantrone) RN - ZS7284E0ZP (Daunorubicin) SB - IM CIN - Lancet. 2010 Dec 11;376(9757):1967-8. PMID: 21131041 MH - Aged MH - Aged, 80 and over MH - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use MH - Cytarabine/administration & dosage MH - Daunorubicin/administration & dosage MH - Female MH - Germany MH - Humans MH - *Internet MH - Leukemia, Myeloid, Acute/*drug therapy/*mortality MH - Male MH - Middle Aged MH - Mitoxantrone/administration & dosage MH - Multivariate Analysis MH - Predictive Value of Tests MH - Prognosis MH - Regression Analysis MH - Remission Induction MH - Risk Assessment MH - Risk Factors MH - Surveys and Questionnaires MH - Time Factors FIR - Fuss, H IR - Fuss H FIR - Hennesser, D IR - Hennesser D FIR - Potenberg, J IR - Potenberg J FIR - Ludwig, W D IR - Ludwig WD FIR - Schondube, D IR - Schondube D FIR - Spath-Schwalbe, E IR - Spath-Schwalbe E FIR - Hesse-Amojo, S IR - Hesse-Amojo S FIR - Mayr, A IR - Mayr A FIR - Gruneisen, A IR - Gruneisen A FIR - Boewer, C IR - Boewer C FIR - Derwahl, M IR - Derwahl M FIR - Englisch, H J IR - Englisch HJ FIR - Rick, O IR - Rick O FIR - Siegert, W IR - Siegert W FIR - Notter, M IR - Notter M FIR - Uharek, L IR - Uharek L FIR - Thiel, E IR - Thiel E FIR - Dorken, B IR - Dorken B FIR - Arnold, R IR - Arnold R FIR - Huhn, D IR - Huhn D FIR - Knigge, O IR - Knigge O FIR - Kolloch, R IR - Kolloch R FIR - Krumpelmann, U IR - Krumpelmann U FIR - Weh, A J IR - Weh AJ FIR - Zumsprekel, A IR - Zumsprekel A FIR - Teschendorf, C IR - Teschendorf C FIR - Stechstor, M IR - Stechstor M FIR - Trenn, G IR - Trenn G FIR - Wormann, B IR - Wormann B FIR - Pfluger, K-H IR - Pfluger KH FIR - Wolff, T IR - Wolff T FIR - Hertenstein, B IR - Hertenstein B FIR - Thomssen, H IR - Thomssen H FIR - Peyn, A IR - Peyn A FIR - Rasche, H IR - Rasche H FIR - Heidtmann, H-H IR - Heidtmann HH FIR - Marquard, F IR - Marquard F FIR - Hahnel, M IR - Hahnel M FIR - Fiedler, F IR - Fiedler F FIR - Herbst, R IR - Herbst R FIR - Hallek, M IR - Hallek M FIR - Staib, P IR - Staib P FIR - Heike, M IR - Heike M FIR - Niederste-Hollenberg, A IR - Niederste-Hollenberg A FIR - Pielken, H IR - Pielken H FIR - Hindahl, H IR - Hindahl H FIR - Rollig, C IR - Rollig C FIR - Schaich, M IR - Schaich M FIR - Thiede, C IR - Thiede C FIR - Kramer, M IR - Kramer M FIR - Ehninger, G IR - Ehninger G FIR - Aul, C IR - Aul C FIR - Giagounidis, A IR - Giagounidis A FIR - Lange, W IR - Lange W FIR - Kuhlemann, S E IR - Kuhlemann SE FIR - Flasshove, M IR - Flasshove M FIR - Karow, J IR - Karow J FIR - Gramatzki, M IR - Gramatzki M FIR - Helm, G IR - Helm G FIR - Fuchs, R IR - Fuchs R FIR - Schlegel, F IR - Schlegel F FIR - Saal, J-G IR - Saal JG FIR - Serve, H IR - Serve H FIR - Kiehl, M IR - Kiehl M FIR - Hoffkes, H-G IR - Hoffkes HG FIR - Arland, M IR - Arland M FIR - Meckenstock, G IR - Meckenstock G FIR - Giagounidis, A IR - Giagounidis A FIR - Haase, D IR - Haase D FIR - Trumper, L IR - Trumper L FIR - Griesinger, F IR - Griesinger F FIR - Gropp, C IR - Gropp C FIR - Depenbusch, R IR - Depenbusch R FIR - Eimermacher, H IR - Eimermacher H FIR - Schutte, W IR - Schutte W FIR - Haak, U IR - Haak U FIR - Fasshaur, E IR - Fasshaur E FIR - Schmitz, N IR - Schmitz N FIR - Stuhlmann, R IR - Stuhlmann R FIR - Braumann, D IR - Braumann D FIR - Schmidt, H IR - Schmidt H FIR - Buhrmann, K IR - Buhrmann K FIR - Balleisen, L IR - Balleisen L FIR - Schubert, J IR - Schubert J FIR - Durk, H IR - Durk H FIR - Burk, M IR - Burk M FIR - Ho, A-D IR - Ho AD FIR - Mahlknecht, U IR - Mahlknecht U FIR - Lange, J G IR - Lange JG FIR - Schmitz-Hubner, U IR - Schmitz-Hubner U FIR - Bartholomaus, A IR - Bartholomaus A FIR - Fauser, A IR - Fauser A FIR - Link, H IR - Link H FIR - Hagmann, F-G IR - Hagmann FG FIR - Wolf, M IR - Wolf M FIR - Ritter, B IR - Ritter B FIR - Frieling, Th IR - Frieling T FIR - Planker, M IR - Planker M FIR - Kochling, G IR - Kochling G FIR - Hartmann, F IR - Hartmann F FIR - Middeke, H IR - Middeke H FIR - Grundgens, C IR - Grundgens C FIR - Constantin, C IR - Constantin C FIR - Schalk, K-P IR - Schalk KP FIR - Jost, K-A IR - Jost KA FIR - Fetscher, S IR - Fetscher S FIR - Schmielau, J IR - Schmielau J FIR - Wagner, T IR - Wagner T FIR - Uppenkamp, M IR - Uppenkamp M FIR - Hoffmann, M IR - Hoffmann M FIR - Hehlmann, R IR - Hehlmann R FIR - Lengfelder, E IR - Lengfelder E FIR - Neubauer, A IR - Neubauer A FIR - Schwonzen, M IR - Schwonzen M FIR - Spangenberg, H IR - Spangenberg H FIR - Bodenstein, H IR - Bodenstein H FIR - Tischler, J IR - Tischler J FIR - Graeven, D IR - Graeven D FIR - Kohl, D IR - Kohl D FIR - Heuer, T IR - Heuer T FIR - Pohlmann, H IR - Pohlmann H FIR - Brack, N IR - Brack N FIR - Nibler, K IR - Nibler K FIR - Fleckenstein, D IR - Fleckenstein D FIR - Haferlach, T IR - Haferlach T FIR - Haferlach, C IR - Haferlach C FIR - Schnittger, S IR - Schnittger S FIR - Kern, W IR - Kern W FIR - Emmerich, B IR - Emmerich B FIR - Dengler, R IR - Dengler R FIR - Schlag, B IR - Schlag B FIR - Hiddemann, W IR - Hiddemann W FIR - Braess, J IR - Braess J FIR - Spiekermann, K IR - Spiekermann K FIR - Berdel, W E IR - Berdel WE FIR - Buchner, T IR - Buchner T FIR - Kienast, J IR - Kienast J FIR - Mesters, R IR - Mesters R FIR - Muller-Tidow, C IR - Muller-Tidow C FIR - Krug, U IR - Krug U FIR - Koschmieder, S IR - Koschmieder S FIR - Volpert, S IR - Volpert S FIR - Wieacker, P IR - Wieacker P FIR - Sauerland, M C IR - Sauerland MC FIR - Heinecke, A IR - Heinecke A FIR - Kopcke, W IR - Kopcke W FIR - Wilhelm, M IR - Wilhelm M FIR - Wandt, H IR - Wandt H FIR - Schafer-Eckart, K IR - Schafer-Eckart K FIR - Hirsch, F IR - Hirsch F FIR - Seeber, B IR - Seeber B FIR - Hartlapp, J IR - Hartlapp J FIR - Hegge, T IR - Hegge T FIR - Peceny, R IR - Peceny R FIR - Koch, O IR - Koch O FIR - Innig, G IR - Innig G FIR - Sudhoff, T IR - Sudhoff T FIR - Wagner, T IR - Wagner T FIR - Maschmeyer, G IR - Maschmeyer G FIR - Kreuser, E D IR - Kreuser ED FIR - Schenk, M IR - Schenk M FIR - Reichle, A IR - Reichle A FIR - Andreesen, R IR - Andreesen R FIR - Huff, H IR - Huff H FIR - Schonberger, D IR - Schonberger D FIR - Geer, T IR - Geer T FIR - Heissmeyer, H IR - Heissmeyer H FIR - Labenz, J IR - Labenz J FIR - Gassmann, W IR - Gassmann W FIR - Gaske, T IR - Gaske T FIR - Kasberger, J IR - Kasberger J FIR - Aulitzky, W E IR - Aulitzky WE FIR - Leimer, L IR - Leimer L FIR - Clemens, M R IR - Clemens MR FIR - Mahlberg, R IR - Mahlberg R FIR - Frickhofen, N IR - Frickhofen N FIR - Fuhr, H-G IR - Fuhr HG FIR - Schwerdtfeger, R IR - Schwerdtfeger R FIR - Augener, W IR - Augener W FIR - Engberding, R IR - Engberding R FIR - Winter, R IR - Winter R FIR - Sandmann, M IR - Sandmann M FIR - Einsele, H IR - Einsele H FIR - Weissinger, F IR - Weissinger F FIR - Ruckle-Lanz, H IR - Ruckle-Lanz H FIR - Brugger, W IR - Brugger W FIR - Papakonstantinou, G IR - Papakonstantinou G FIR - Kreibich, U IR - Kreibich U FIR - Schott, G IR - Schott G FIR - Sommer, S IR - Sommer S FIR - Zschille, W IR - Zschille W EDAT- 2010/12/07 06:00 MHDA- 2010/12/29 06:00 CRDT- 2010/12/07 06:00 PHST- 2010/12/07 06:00 [entrez] PHST- 2010/12/07 06:00 [pubmed] PHST- 2010/12/29 06:00 [medline] AID - S0140-6736(10)62105-8 [pii] AID - 10.1016/S0140-6736(10)62105-8 [doi] PST - ppublish SO - Lancet. 2010 Dec 11;376(9757):2000-8. doi: 10.1016/S0140-6736(10)62105-8. Epub 2010 Dec 3.