Krankenhausbett, in dem AML Patienten liegen
©CC0/arembowski

How many people diagnosed with Acute Myeloid Leukemia (AML) are treated in Germany every year? How much does the therapy cost and which are the best clinics? In this article, you will find the answers to these and other questions.

Survival probability

Is leukemia curable? This is what people diagnosed with the disease ask themselves first. Good news: the chance of survival improved over the last decades. Fifty years ago, AML was almost always fatal. However, today the survival probability for children and adolescents is at 70 percent. For adults, the 5-year survival rate is lower:

  • patients under 30 years = 60 %
  • patients between 45 and 54 years = 43 %
  • patients between 55 and 64 years = 23 %

Please note that although the survival rates above are taken from the current Guideline for AML (available in German), it represents data that has been collected between 1997 and 2006. There are other factors that influence the survival rate: for example the social environment, genetic predisposition, the aggressiveness of the cancer and individual lifestyle. Thus, the statistical values illustrated above are only significant to a limited extent.

Causes and frequency

Acute myeloid leukemia is neither contagious nor can it be transmitted to other people. This disease results from malignant genetic modifications in the bone marrow. Possible causes are:

  • ionizing radiation, e.g. after an accent in a nuclear reactor
  • long-term exposure to particular chemical substances, such as benzene
  • medicine which is used itself for the treatment of cancerous conditions
  • genetic predisposition: people with Down syndrome are at increased risk of leukemia

In most cases, the cause of the disease is completely unclear.

As there are 3,7 cases per 100,000 inhabitants, AML is considered a rare disease. Older people are affected more often. According to the Guideline, for older people, there are approximately 100 cases per 100,000 inhabitants.

This is how many people in Germany are diagnosed with AML

Symptoms

The symptoms of AML often develop over only a few weeks, because there is a lack of normal blood cells and organs such as the liver and the spleen are infected by myeloid blasts. Some patients have very few symptoms, so the disease may be discovered incidentally during a routine blood test.

Possible symptoms of AML

  • Anemia, which results in fatigue, weakness, shortness of breath and indisposition
  • Fever and/or increased susceptibility of infection
  • Loss of appetite and stomach pains
  • Bruises, frequent nosebleed, bleeding gums due to the reduction in the number of thrombocytes
  • Bone and joint pains, because the blasts spread into the bones
  • Lymph node swelling in the neck, armpit or groin area

However, these symptoms can also occur in other comparatively harmless diseases. In any case, you should consult a doctor as quickly as possible in order to narrow down the clinical picture.

Clinics for Leukemia

In Germany, AML is treated in more than 900 clinics. Nevertheless, not all hospitals have experienced doctors or the necessary equipment at hand. Ten excellent clinics for the treatment of leukemia are presented here.

HospitalCityTreatment Cases (2019)International Office 
University Hospital MünsterMünster543Yes
Munich University HospitalMunich501Yes
University Hospital Hamburg-EppendorfHamburg414Yes
University Hospital JenaJena399No
University Hospital UlmUlm375Yes
University Hospital CologneCologne373Yes
University Hospital WürzburgWürzburg340Yes
Medical School HannoverHannover325Yes
University Hospital LeipzigLeipzig309No
University Hospital FreiburgFreiburg305Yes
University Hospital TübingenTübingen305Yes
University Hospital EssenEssen296Yes
University Hospital ErlangenErlangen290Yes
University Hospital HeidelbergHeidelberg269Yes
University Medicine of the Johannes Gutenberg University MainzMainz268Yes
Helios Clinic ErfurtErfurt257Yes
Stuttgart ClinicStuttgart252Yes
University Hospital Halle (Saale)Halle (Saale)244Yes

Do you want to know which criteria were used to create this list? Find out here.

Different forms of therapy

AML is a serious illness that has to be treated immediately. That is why doctors and patients start the therapy directly after the diagnosis has been made so that the leukemia cells can be killed quickly and the bone marrow can begin with the blood formation. The following therapies are used:

Chemotherapy
Chemotherapy forms the basis of AML therapy. The patient is administered an anticancer drug in order to kill or minimize cancer cells and to prevent them from spreading.

Radiotherapy
Radiotherapy is used when the blood cancer has already affected other regions of the body, and before a stem cell transplantation is carried out.

Medicine against side effects
Unfortunately, chemo- and radiotherapy cause side effects such as nausea, infections, anemia and/or pain. Therefore, drugs are used to reduce these side effects.

Stem cell transplantation
A stem cell transplantation is mostly carried out when chemotherapy was not successful or when there is an increased risk of relapse due to the characteristics of the leukemic cells.

The choice of the therapy depends on different factors. The list above should only serve as an overview. In the end, the doctor decides which forms of therapy are necessary.

Treatment costs

The treatment costs depend on several factors. A treatment by the head physician will be more expensive. You also pay more for a single room. There are additional costs for patients from abroad such as travel expenses, the visa, accommodation of family members and possibly interpreting or translation services. In Germany, all patients pay the same. It does not matter if a patient comes from Germany or from abroad.

Costs for the AML therapy in a German clinic

TreatmentCostsDays in hospitalName DRG  
AML - no chemotherapy2,963 euros6.4 daysR60F
AML - with chemotherapy6,821 euros13.5 daysR60D
AML - with chemotherapy and stay on the ICU18,793 euros32.3 daysR60B

The basis for the calculation of the prices above is the so-called flat-rate catalogue. The costs and the duration of the stay in hospital varies depending on the severity of illness and the secondary illnesses. But beware: the prices and the number of days spent in hospital represented above should only serve as an orientation. The treating physicians will eventually decide on the length of the hospital stay and the type of therapy. Also, the outpatient pre- and post-treatment is not included in the prices above.

Do you have questions about AML or another form of leukemia? Write us an email.