Chronic myeloid leukemia in the elderly: Long-term results from randomized trials with interferon α

U. Berger; G. Englich; O. Maywald; M. Pfirrmann; A. Hochhaus; A. Reiter; G. Metzgeroth; U. Gnad; J. Hasford; B. Heinze; H. Heimpel; D. K. Hossefeld; H. J. Kolb; H. Löffer; H. Pralle; W. Queisser; R. Hehlmann; C. Nerl; W. Kaboth; R. Hartenstein; N. Brack; J. Rastetter; M. Perker; N. Zöllner; M. Jahn; M. Garbrecht; H. J. Schäfer; A. Wohlrab; K. Überla; J. Hasford; H. Ansari; M. Pfirrmann; B. Rath; H. Eggebrecht; D. Nürnberg; W. Brockhaus; W. M. Gallmeier; C. Falge; A. Brunöhler; F. del Valle; K. Ranft; G. Meuret; S. Mende; W. Wellens; J. Weiß; M. Schenk; H. H. Heißmeyer; T. Geer; T. Cerny; L. Schmid; G. Biedermann; H. Heimpel; M. Griesshammer; T. M. Fliedner; B. Heinze; L. Labedzki; N. Frickhofen; H. G. Fuhr; W. Augener; K. Wilms; M. Wilhelm; H. Rückle-Lanz

doi:10.1038/sj.leu.2403042

Chronic myeloid leukemia in the elderly: Long-term results from randomized trials with interferon α

U. Berger
, G. Englich
, O. Maywald
, M. Pfirrmann
, A. Hochhaus
, A. Reiter
, G. Metzgeroth
, U. Gnad
, J. Hasford
, B. Heinze
, H. Heimpel
, D. K. Hossefeld
, H. J. Kolb
, H. Löffer
, H. Pralle
, W. Queisser
, R. Hehlmann
, C. Nerl
, W. Kaboth
, R. Hartenstein

N. Brack, J. Rastetter, M. Perker, N. Zöllner, M. Jahn, M. Garbrecht, H. J. Schäfer, A. Wohlrab, K. Überla, J. Hasford, H. Ansari, M. Pfirrmann, B. Rath, H. Eggebrecht, D. Nürnberg, W. Brockhaus, W. M. Gallmeier, C. Falge, A. Brunöhler, F. del Valle, K. Ranft, G. Meuret, S. Mende, W. Wellens, J. Weiß, M. Schenk, H. H. Heißmeyer, T. Geer, T. Cerny, L. Schmid, G. Biedermann, H. Heimpel, M. Griesshammer, T. M. Fliedner, B. Heinze, L. Labedzki, N. Frickhofen, H. G. Fuhr, W. Augener, K. Wilms, M. Wilhelm, H. Rückle-Lanz

Heidelberg University
Ludwig-Maximilians-Universität München
III. Medizinische Klinik
Universitätsklinikum Hamburg-Eppendorf
Municipal Hospital Kiel GmbH
Zentrum fur Innere Medizin
Stadt. Krankhs. Munchen-Harlaching
Krankenhaus Neuperlach
Universitätsklinikum Münster
Med. Klinik B
Medizinische Klinik
Gemeinschaftspraxis
Klinikum Oldenburg
Stadt. Krankenhaus
Krankenhaus St. Elisabeth
Krankenhaus der Barmherzigen Bruder
Diakonie-Krankenhaus
Kantonsspital
Onkologische Abteilung
University Medical Center Ulm and Center of Excellence 'Metabolic Disorders'
Med. Klinik
Dr. Horst-Schmidt-Klinik
St.-Willehad Hospital
University Hospital Würzburg

Research output: Contribution to journal › Article › peer-review

25 Scopus citations

Abstract

Chronic myeloid leukemia (CML) in older patients has not been studied well. To assess the long-term outcome of older patients with Philadelphia- and/or BCR-ABL-positive CML, 199 patients aged ≥ 60 years representing 23% of 856 patients enrolled in the German randomized CML-studies I (interferon α (IFN) vs hydroxyurea (HU) vs busulfan (BU) and II (IFN+HU vs HU alone) were analyzed after a median observation time of 7 years. In all, 45 patients were treated with Bu, 63 with HU, and 91 with IFN. The 5-year survival was 38% in patients ≥ 60 years and 47% in patients < 60 years (P < 0.001). Whereas 5-year survival in chemotherapy-treated older patients was inferior to that in younger patients (33 vs 46%, P = 0.006 for HU and 29 vs 38%, P = 0.042 for Bu), no significant survival difference could be verified in IFN-treated patients (46 vs 53%, P = 0.077). Calculation of age-adjusted, relative survival confirmed these results. Adverse effects of IFN were similar in both age groups, but IFN dosage to achieve treatment goals was lower in older patients. We conclude that the course of CML is not different in the elderly. They require lower IFN doses, achieve the same hematologic and cytogenetic response rates and the same survival advantage at comparable toxicity.

Original language	English
Pages (from-to)	1820-1826
Number of pages	7
Journal	Leukemia
Volume	17
Issue number	9
DOIs	https://doi.org/10.1038/sj.leu.2403042
State	Published - 1 Sep 2003
Externally published	Yes

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

CML
Elderly patients
Interferon α
Survival

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10.1038/sj.leu.2403042

Cite this

Berger, U., Englich, G., Maywald, O., Pfirrmann, M., Hochhaus, A., Reiter, A., Metzgeroth, G., Gnad, U., Hasford, J., Heinze, B., Heimpel, H., Hossefeld, D. K., Kolb, H. J., Löffer, H., Pralle, H., Queisser, W., Hehlmann, R., Nerl, C., Kaboth, W., ... Rückle-Lanz, H. (2003). Chronic myeloid leukemia in the elderly: Long-term results from randomized trials with interferon α. Leukemia, 17(9), 1820-1826. https://doi.org/10.1038/sj.leu.2403042

@article{aa10a74925b24abdbcbca8347f0777f8,

title = "Chronic myeloid leukemia in the elderly: Long-term results from randomized trials with interferon α",

abstract = "Chronic myeloid leukemia (CML) in older patients has not been studied well. To assess the long-term outcome of older patients with Philadelphia- and/or BCR-ABL-positive CML, 199 patients aged ≥ 60 years representing 23\% of 856 patients enrolled in the German randomized CML-studies I (interferon α (IFN) vs hydroxyurea (HU) vs busulfan (BU) and II (IFN+HU vs HU alone) were analyzed after a median observation time of 7 years. In all, 45 patients were treated with Bu, 63 with HU, and 91 with IFN. The 5-year survival was 38\% in patients ≥ 60 years and 47\% in patients < 60 years (P < 0.001). Whereas 5-year survival in chemotherapy-treated older patients was inferior to that in younger patients (33 vs 46\%, P = 0.006 for HU and 29 vs 38\%, P = 0.042 for Bu), no significant survival difference could be verified in IFN-treated patients (46 vs 53\%, P = 0.077). Calculation of age-adjusted, relative survival confirmed these results. Adverse effects of IFN were similar in both age groups, but IFN dosage to achieve treatment goals was lower in older patients. We conclude that the course of CML is not different in the elderly. They require lower IFN doses, achieve the same hematologic and cytogenetic response rates and the same survival advantage at comparable toxicity.",

keywords = "CML, Elderly patients, Interferon α, Survival",

author = "U. Berger and G. Englich and O. Maywald and M. Pfirrmann and A. Hochhaus and A. Reiter and G. Metzgeroth and U. Gnad and J. Hasford and B. Heinze and H. Heimpel and Hossefeld, \{D. K.\} and Kolb, \{H. J.\} and H. L{\"o}ffer and H. Pralle and W. Queisser and R. Hehlmann and C. Nerl and W. Kaboth and R. Hartenstein and N. Brack and J. Rastetter and M. Perker and N. Z{\"o}llner and M. Jahn and M. Garbrecht and Sch{\"a}fer, \{H. J.\} and A. Wohlrab and K. {\"U}berla and J. Hasford and H. Ansari and M. Pfirrmann and B. Rath and H. Eggebrecht and D. N{\"u}rnberg and W. Brockhaus and Gallmeier, \{W. M.\} and C. Falge and A. Brun{\"o}hler and \{del Valle\}, F. and K. Ranft and G. Meuret and S. Mende and W. Wellens and J. Wei{\ss} and M. Schenk and Hei{\ss}meyer, \{H. H.\} and T. Geer and T. Cerny and L. Schmid and G. Biedermann and H. Heimpel and M. Griesshammer and Fliedner, \{T. M.\} and B. Heinze and L. Labedzki and N. Frickhofen and Fuhr, \{H. G.\} and W. Augener and K. Wilms and M. Wilhelm and H. R{\"u}ckle-Lanz",

year = "2003",

month = sep,

day = "1",

doi = "10.1038/sj.leu.2403042",

language = "English",

volume = "17",

pages = "1820--1826",

journal = "Leukemia",

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Berger, U, Englich, G, Maywald, O, Pfirrmann, M, Hochhaus, A, Reiter, A, Metzgeroth, G, Gnad, U, Hasford, J, Heinze, B, Heimpel, H, Hossefeld, DK, Kolb, HJ, Löffer, H, Pralle, H, Queisser, W, Hehlmann, R, Nerl, C, Kaboth, W, Hartenstein, R, Brack, N, Rastetter, J, Perker, M, Zöllner, N, Jahn, M, Garbrecht, M, Schäfer, HJ, Wohlrab, A, Überla, K, Hasford, J, Ansari, H, Pfirrmann, M, Rath, B, Eggebrecht, H, Nürnberg, D, Brockhaus, W, Gallmeier, WM, Falge, C, Brunöhler, A, del Valle, F, Ranft, K, Meuret, G, Mende, S, Wellens, W, Weiß, J, Schenk, M, Heißmeyer, HH, Geer, T, Cerny, T, Schmid, L, Biedermann, G, Heimpel, H, Griesshammer, M, Fliedner, TM, Heinze, B, Labedzki, L, Frickhofen, N, Fuhr, HG, Augener, W, Wilms, K, Wilhelm, M & Rückle-Lanz, H 2003, 'Chronic myeloid leukemia in the elderly: Long-term results from randomized trials with interferon α', Leukemia, vol. 17, no. 9, pp. 1820-1826. https://doi.org/10.1038/sj.leu.2403042

TY - JOUR

T1 - Chronic myeloid leukemia in the elderly

T2 - Long-term results from randomized trials with interferon α

AU - Berger, U.

AU - Englich, G.

AU - Maywald, O.

AU - Pfirrmann, M.

AU - Hochhaus, A.

AU - Reiter, A.

AU - Metzgeroth, G.

AU - Gnad, U.

AU - Hasford, J.

AU - Heinze, B.

AU - Heimpel, H.

AU - Hossefeld, D. K.

AU - Kolb, H. J.

AU - Löffer, H.

AU - Pralle, H.

AU - Queisser, W.

AU - Hehlmann, R.

AU - Nerl, C.

AU - Kaboth, W.

AU - Hartenstein, R.

AU - Brack, N.

AU - Rastetter, J.

AU - Perker, M.

AU - Zöllner, N.

AU - Jahn, M.

AU - Garbrecht, M.

AU - Schäfer, H. J.

AU - Wohlrab, A.

AU - Überla, K.

AU - Hasford, J.

AU - Ansari, H.

AU - Pfirrmann, M.

AU - Rath, B.

AU - Eggebrecht, H.

AU - Nürnberg, D.

AU - Brockhaus, W.

AU - Gallmeier, W. M.

AU - Falge, C.

AU - Brunöhler, A.

AU - del Valle, F.

AU - Ranft, K.

AU - Meuret, G.

AU - Mende, S.

AU - Wellens, W.

AU - Weiß, J.

AU - Schenk, M.

AU - Heißmeyer, H. H.

AU - Geer, T.

AU - Cerny, T.

AU - Schmid, L.

AU - Biedermann, G.

AU - Heimpel, H.

AU - Griesshammer, M.

AU - Fliedner, T. M.

AU - Heinze, B.

AU - Labedzki, L.

AU - Frickhofen, N.

AU - Fuhr, H. G.

AU - Augener, W.

AU - Wilms, K.

AU - Wilhelm, M.

AU - Rückle-Lanz, H.

PY - 2003/9/1

Y1 - 2003/9/1

N2 - Chronic myeloid leukemia (CML) in older patients has not been studied well. To assess the long-term outcome of older patients with Philadelphia- and/or BCR-ABL-positive CML, 199 patients aged ≥ 60 years representing 23% of 856 patients enrolled in the German randomized CML-studies I (interferon α (IFN) vs hydroxyurea (HU) vs busulfan (BU) and II (IFN+HU vs HU alone) were analyzed after a median observation time of 7 years. In all, 45 patients were treated with Bu, 63 with HU, and 91 with IFN. The 5-year survival was 38% in patients ≥ 60 years and 47% in patients < 60 years (P < 0.001). Whereas 5-year survival in chemotherapy-treated older patients was inferior to that in younger patients (33 vs 46%, P = 0.006 for HU and 29 vs 38%, P = 0.042 for Bu), no significant survival difference could be verified in IFN-treated patients (46 vs 53%, P = 0.077). Calculation of age-adjusted, relative survival confirmed these results. Adverse effects of IFN were similar in both age groups, but IFN dosage to achieve treatment goals was lower in older patients. We conclude that the course of CML is not different in the elderly. They require lower IFN doses, achieve the same hematologic and cytogenetic response rates and the same survival advantage at comparable toxicity.

AB - Chronic myeloid leukemia (CML) in older patients has not been studied well. To assess the long-term outcome of older patients with Philadelphia- and/or BCR-ABL-positive CML, 199 patients aged ≥ 60 years representing 23% of 856 patients enrolled in the German randomized CML-studies I (interferon α (IFN) vs hydroxyurea (HU) vs busulfan (BU) and II (IFN+HU vs HU alone) were analyzed after a median observation time of 7 years. In all, 45 patients were treated with Bu, 63 with HU, and 91 with IFN. The 5-year survival was 38% in patients ≥ 60 years and 47% in patients < 60 years (P < 0.001). Whereas 5-year survival in chemotherapy-treated older patients was inferior to that in younger patients (33 vs 46%, P = 0.006 for HU and 29 vs 38%, P = 0.042 for Bu), no significant survival difference could be verified in IFN-treated patients (46 vs 53%, P = 0.077). Calculation of age-adjusted, relative survival confirmed these results. Adverse effects of IFN were similar in both age groups, but IFN dosage to achieve treatment goals was lower in older patients. We conclude that the course of CML is not different in the elderly. They require lower IFN doses, achieve the same hematologic and cytogenetic response rates and the same survival advantage at comparable toxicity.

KW - CML

KW - Elderly patients

KW - Interferon α

KW - Survival

UR - https://www.scopus.com/pages/publications/0141502204

U2 - 10.1038/sj.leu.2403042

DO - 10.1038/sj.leu.2403042

M3 - Article

C2 - 12970782

AN - SCOPUS:0141502204

SN - 0887-6924

VL - 17

SP - 1820

EP - 1826

JO - Leukemia

JF - Leukemia

IS - 9

ER -

Chronic myeloid leukemia in the elderly: Long-term results from randomized trials with interferon α

Abstract

UN SDGs

Keywords

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