The Berlin-Frankfurt-Münster (BFM) Group was established in 1976 with the goal of cooperating in the field of acute lymphoblastic leukemia (ALL). In 1978, this collaboration was expanded to include acute myeloid leukemia (AML). In the 1970s, the study group was initiated by Prof. Günther Schellong (University Children's Hospital Münster) and led together with Prof. Ursula Creutzig and Prof. Jörg Ritter.
Since 2005, the AML-BFM study group has been led by Prof. Dr. Dirk Reinhardt. Currently, approximately 60 pediatric clinics in Germany, Austria, Switzerland, the Czech Republic, Slovakia, and Poland are cooperating within this network.
During the first five AML-BFM studies, from 1978 to 2004, a total of 2,900 children and adolescents with AML were treated. The first cooperative AML-BFM study (AML-BFM 78) established a treatment protocol that included intensive chemotherapy with seven drugs, radiation of the central nervous system (CNS), and a two-year maintenance therapy, achieving a long-term survival rate (overall survival, OS) of 40%. Intensification of induction therapy (i.e., the first chemotherapy block) led to a significant improvement in disease-free survival (DFS) in the follow-up study AML-BFM 83. The risk of bleeding, especially in children with hyperleukocytosis, i.e., a very high number of white blood cells—also required a greater focus on supportive care measures, which were developed and implemented by the AML-BFM study group. With the AML-BFM 87 study, the benefit of CNS radiation in preventing CNS and systemic relapses was demonstrated. The introduction of induction therapy with the drug Idarubicin and a HAM intensification block further improved the 5-year survival rate to 62% (±3%) in the AML-BFM 93 and 98 studies. It was shown that stem cell transplantation (SCT), as performed in high-risk patients with an HLA-identical related donor, did not provide significant advantages over chemotherapy alone. Despite the increasing intensity of treatment from study to study, the therapy-related mortality rate decreased—especially during the induction phase.
Currently, more than 65% of all children and adolescents with AML in Germany can be cured.
Future goals of the cooperative AML-BFM studies, in addition to further improving survival rates, include reducing therapy-related long-term effects (e.g., cardiotoxicity, i.e., therapy-induced heart damage) by administering drugs with lower cardiotoxic effects and adapting therapy individually according to the patient's specific prognostic factors. This includes more targeted therapy options based on the biological characteristics of leukemia.
You can find out more about our current clinical trials and registries here.
The standardization of treatment concepts, along with thirty years of intensive national and international collaboration, has significantly improved the survival rates of children and adolescents with acute myeloid leukemia. Nevertheless, continued cooperation in treatment and research is essential to gain deeper insights into the development and treatment of leukemia. This knowledge is crucial for responding to this severe disease with appropriate therapy options—and, in the future, potentially preventing its onset altogether.