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Russia and the United States are close to reaching an understanding on Syria’s Aleppo, Russian Deputy Foreign Minister Sergei Ryabkov has said.

“In the past several days an intensive document exchange on the situation in Aleppo has taken place,” Ryabkov was quoted as saying in the Interfax news agency yesterday.

“We are close to reaching an understanding, but I want to warn against high expectations,” Ryabkov added.

The Kremlin said on Wednesday that a potential US-Russia deal to allow Syrian rebels to safely leave Aleppo was still on the agenda.

Russian Foreign Minister Sergei Lavrov was due to meet US Secretary of State John Kerry in Hamburg later yesterday after the two diplomats held brief talks on Wednesday.

Aleppo, Syria’s second largest city, has been divided between government-controlled neighbourhoods in the city’s west and rebel-held areas in the east since 2012.

The Syrian government and its allied forces reportedly control at least three-quarters of formerly rebel-held eastern Aleppo due to a massive military assault on the besieged area.

Government forces scored an important victory on Wednesday when the rebels retreated from the Old City, the historic heart of Aleppo.

They extended their advances later in the day, seizing the Bab al-Nayrab, Al-Maadi and Salhin neighbourhoods, according to state media.

While rebels have vowed to continue fighting, the battle is complicated by tens of thousands of fearful civilians trapped in the remaining portions of the rebel-held east.

And as winter set in, siege conditions are increasingly desperate, exacerbated by increasing numbers of displaced residents and food and water shortages.

“It’s true that Aleppo will be a win for us, but                                     let’s be realistic — it won’t mean the end of the war in Syria,” Syrian President Bashar al-Assad told the al-Watan newspaper. “But it will be a huge step towards this end.”

The Syrian Civil Defence, a first responder group also known as the White Helmets, said air strikes and shelling on Wednesday killed 61 people in what’s left of the rebel-held areas.

Nearly 150 civilians, most disabled or in need of medical care, were evacuated overnight from a hospital in Aleppo’s Old City, the first major evacuation from the eastern sector, the International Committee of the Red Cross said yesterday.

Among those evacuated from Dar Al-Safaa hospital in the Old City — taken over by Syrian government forces on Tuesday — 118 patients were taken to three hospitals in the west of Aleppo and 30 people were taken to shelters, also in the west of the city, the ICRC said.

The evacuation was conducted jointly with the Syrian Arab Red Crescent, it added.

Speaking to reporters yesterday, ICRC spokesperson Pawel Krzysiek said: “The people were basically trapped there [in recent days].

“The fighting kind of slowed down starting from yesterday afternoon,” he continued, adding that “it was too dangerous” to carry out an evacuation earlier.

“It’s first and utmost about the safety of those people [being evacuated] and our priority is to ensure that they will be helped . . . and safely transported to a safer place.”

Speaking of the meeting between Kerry and Lavrov, Middle East analyst James Denslow, said that “the fate of hundreds of thousands of Syrian civilians seems to now rest upon these two individuals in Hamburg”.

Since it began in March 2011, the war in Syria has killed hundreds of thousands of people, made more than half of Syrians homeless, and created the world’s worst refugee crisis.

Assad has ruled out the possibility of a negotiated ceasefire with rebel forces.

“If you look at previous tactics used elsewhere in the country, the besieging of urban areas, heavy attacks and then an agreement to have fighters leave has been used previously,” Denslow said.

“If Assad wants to win his biggest city back, it’s not much of a victory if the city is destroyed or if the population is decimated.” — Al Jazeera