Acute Myeloid Leukemia (AML): Your Chances for Recovery (Prognosis)
What is a prognosis?
Prognosis is the word your healthcare team may use to describe your likely outcome from your leukemia and its treatment. A prognosis is a calculated guess. It’s a question many people have when they learn they have cancer.
Making a choice
The decision to ask about your prognosis is a personal one. It’s up to you to decide how much you want to know. Some people find it easier to cope and plan ahead when they know their prognosis and the statistics for how well a treatment might work. Other people find statistics confusing and frightening. Or they might think statistics are too general to be useful.
A doctor who is most familiar with your health is in the best position to discuss your prognosis with you and explain what the statistics may mean in your case. At the same time, you should keep in mind that your prognosis can change. Cancer and cancer treatment outcomes are hard to predict. For instance, a favorable prognosis (which means you’re likely going to do well) can change if the cancer keeps growing or doesn’t respond to treatment. An unfavorable prognosis can change, too. This can happen if treatment controls the AML so it doesn’t grow more.
What goes into a prognosis
When figuring out your prognosis, your doctor will consider all the things that could affect the leukemia and its treatment. Your doctor will look at risk estimates about the exact type of leukemia you have. These estimates are based on what results researchers have seen over decades in many people with the same type of leukemia.
If your AML is likely to respond well to treatment, your doctor will say you have a favorable prognosis. If your leukemia is likely to be hard to control, your prognosis may be less favorable. In this case, the leukemia may shorten your life. It’s important to keep in mind that a prognosis states what’s likely or probable. It is not a prediction of what will definitely happen. No doctor can be fully certain about an outcome.
Your prognosis depends mainly on:
The subtype of AML
Your age and overall health
Your health history (such as if you've had a blood disease or have had chemotherapy for another cancer in the past)
Gene or chromosome changes in the leukemia cells
If you have a very high white blood cell (WBC) count at diagnosis (greater than 100,000)
If there are leukemia cells in your brain and spinal cord (called CNS or central nervous system involvement). This is very rare.
If you have a bad infection when you're diagnosed
How well your leukemia responds to treatment
Understanding survival rates
Survival rates show how many people live for a certain length of time after being told they have cancer. Most often, the numbers used refer to the 5-year survival rate. That’s how many people live at least 5 years after being diagnosed.
People whose AML doesn’t come back (relapse) in 5 years are usually cured. People who had AML that relapsed but then went into a second remission for 5 years are likely to be cured.
What are the survival rates for AML?
AML survival rates vary a lot based on the leukemia subtype and the factors listed above. The relative 5-year survival rate for people diagnosed with AML is 27%. This number is adjusted for the fact that some people with AML will die from causes other than AML. It's based on people who were diagnosed between 2006 and 2012. Many new and better treatments for AML have become available in recent years. So the prognosis for people diagnosed with AML today is likely better. In fact, treatment advances have almost doubled the 5-year survival rate for leukemias as a combined group. And new treatments are regularly being developed.
It's important to remember: You are not a statistic. Talk with your doctor so that you can understand what long-term treatment outcomes you can expect.
Talking with your healthcare provider
You can ask your healthcare provider about survival rates and what you might expect. But remember that statistics are based on large groups of people treated at least 5 years ago. They can’t be used to say what will happen to you. No two people are exactly alike. Treatment and how well people respond to treatment vary.
March 01, 2018
Levy, Adam S, MD,Stump-Sutliff, Kim, RN, MSN, AOCNS