Long-term follow-up of the AML97 study for patients aged 60 years and above with acute myeloid leukaemia: a study of the East German Haematology and Oncology Study Group (OSHO).

INTRODUCTION: Treatment of patients (pts) with acute myelogenous leukaemia (AML) above 60 years remains a challenge. We report long-term follow-up of the AML97 study, where pts were registered at diagnosis and received treatment dependent on their comorbidities: dose-intense cytarabine (AraC) and anthracycline in the curative arm, and low-dose chemotherapy in the palliative arm or best supportive care. MATERIALS AND METHODS: A total of 618 pts were enrolled in this protocol (curative 471, palliative 115 and supportive 32). In the curative arm, complete remission (CR) was obtained in 66.8 % of pts and the estimated probability of being alive at 2 years was 0.30 (±0.02 SE). In multivariate analysis, gender (p = 0.005), performance status (p = 0.04) and cytogenetics (p = 0.002) were significant factors for CR. With a median follow-up of 10 (range 0.1-11.8) years, the estimated probability of being event-free after 2 and 5 years according to cytogenetics was 0.48 ± 0.11 and 0.48 ± 0.11 for favourable, 0.20 ± 0.03 and 0.09 ± 0.03 for normal, 0.18 ± 0.06 and 0.10 ± 0.05 for other standard risk and 0.10 ± 0.03 and 0.05 ± 0.02 for unfavourable karyotypes, respectively. The median survival time for pts treated with palliative chemotherapy was 54 and 11 days with best supportive care only. CONCLUSION: In conclusion, treatment of older AML pts with dose-intense AraC is feasible in the majority of pts and induces high rates of CR. Nevertheless, except for favourable karyotype, OS and event-free survival remain low. These results need to be viewed in relation to the new modalities including stem cell transplantation following non-myeloablative conditioning, epigenetic and molecular therapies.

[Carcinoma of the gastric stump in routine gastroscopies]. / Magenstumpfkarzinom bei Routinegastroskopien.

205-patients after partial resection of the stomach for benign gastroduodenal ulcers (104 patients for gastric ulcers, 81 patients for duodenal ulcers, 14 patients for combined ulcers) were examined gastroscopically from 1970--1976. The operation was performed more than 5 years ago. 35 carcinomas of the gastric stump could be found (17%). The operation was done in 695 of all cases more than 20 years ago and the male/female relation was estimated to be 6:1. --In 170 other patients with resection of the stomach (61 patients for primary gastric carcinoma, 103 for benign ulcers and 6 for other reasons) with a postoperative interval fewer than 5 years, 10 relapse of carcinoma and 4 carcinomas of the stump were observed. These 4 carcinomas of the stump must be seen as relapses of an carcinoma primarily diagnosed as an ulcer. Gastroscopic-bioptic examinations of patients with an operation performed more than 10 years ago for benign lesions should be done every year. If the cause of operation had been a carcinoma than from the first year after operation.