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Büchner abstract

Please cite this article as follows: Büchner Th. Raisa Gorbacheva Memorial Lecture. Treatment of Acute Myeloid Leukemia: Present Status and New Directions. Cell Ther Transplant. 2008;1:e.2008-05-30-001-en. doi:10.3205/ctt2008-05-30-001-en

Treatment of acute myeloid leukemia: present status and new directions

Thomas Büchner
Abstract

The article is introduced by a tribute to the huge merits of Mrs. Raisa Gorbacheva's anti-leukemia campaign. Raisa Gorbacheva and her husband, Mr. Michael Gorbachev, have contributed greatly to the arrangement and funding of childhood leukemia treatment in Russia. The review article also covers the basic issues to do with acute myeloid leukemia (AML) treatment, including the general concepts of myeloablative therapy. Over four decades, improvements in therapeutic approaches have resulted in a gradual increase in complete remission rates and general survival of AML patients. However, further intensification of conventional treatments failed to increase the patients' long-term survival. A significantly lower survival rate among older patients (>60 years of age) is found when using this approach. Recent developments are associated with the usage of chromosome and gene aberrations as valuable markers to predict the treatment results and survival in AML. For example, a mutated nucleophosmin 1 gene in the absence of a FLT3 mutation is an age-independent predictor of a favorable outcome in AML. Decisive progress in AML treatment has been achieved when applying intensive chemotherapy followed by allogeneic transplantation of hematopoietic stem cells (allo-HSCT). This approach is clearly superior to conventional therapy in terms of relapse-free survival. However, comparative efficiency for different therapies presents some statistical controversies (e.g., biased patient selection in Matched Pair analysis). Allo-HSCT is still associated with considerable transplant-associated mortality, thus affecting overall survival rates. To avoid early mortality, a reduced-intensity conditioning may be considered, especially for older patients. Most clinical trials in AML are performed as multicentre therapeutic trials (e.g., within the European Leukemia Network): thus providing faster progress in the development of a more efficient AML treatment.

Keywords: acute myeloid leukemia, therapy, hematopoietic stem cell transplantation (HSCT), efficiency, Gorbacheva

Please cite this article as follows: Büchner Th. Raisa Gorbacheva Memorial Lecture. Treatment of Acute Myeloid Leukemia: Present Status and New Directions. Cell Ther Transplant. 2008;1:e.2008-05-30-001-en. doi:10.3205/ctt2008-05-30-001-en

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