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Can I Survive Acute Myeloid Leukemia (AML)? What Is My Prognosis?

It may sound harsh to ask the question, “Can I survive this?” But it’s a question on the minds of most people facing a diagnosis of leukemia. And hearing the answer can be just as hard as asking the question.

The chance that you will recover or have a recurrence depends on many factors, including the type of leukemia, how well it responds to treatment, and your age and general health. 

Before discussing your prognosis with you, your doctor will consider all the things that could affect your disease and treatment. Your doctor will then predict what seems likely to happen. To do that, the doctor will look at what researchers have found out over many years about thousands of people with leukemia. When possible, the doctor will use statistics for groups of people whose situations are most like yours to make a prediction.

If your cancer is likely to respond well to treatment, your doctor will say you have a favorable prognosis. If the leukemia is likely to be hard to control, your prognosis may be unfavorable. It is important to keep in mind, though, that a prognosis states what is probable. It is not a prediction of what will happen. No doctor can be absolutely certain about the outcome.

Some people find it easier to cope when they know their prognosis and the statistics for how well a treatment might work. Other people find statistical information confusing and frightening. Or they might think it is too general to be useful. The doctor who is most familiar with your situation is in the best position to discuss your prognosis with you and explain what the statistics may mean for you. At the same time, you should keep in mind that a person’s prognosis may change. A favorable prognosis can change if the leukemia progresses. An unfavorable one can change if treatment is successful. The decision to ask about your prognosis is a personal one. It is up to you to decide how much you want to know.

What does the 5-year survival rate mean?

Survival rates show the percentage of people who live for a specific length of time after being told they have leukemia. Survival rates are based on large groups of people. They cannot be used to predict what will happen to a particular person. No 2 people are exactly alike, and treatment and responses to treatment vary greatly. Often, statistics refer to the 5-year survival rate, which is the percentage of people who live at least 2 years after diagnosis. The survival rate includes people at these different stages:

  • People who achieved a complete remission and have remained continuously free of disease and are likely cured.

  • People who have had a prior relapse but are currently in remission.

  • People who have active leukemia.

Many of these people live much longer than 5 years after diagnosis. Because the statistics we have for 5-year rates now are based on people diagnosed and first treated more than 5 years ago, it’s possible that the outlook could be more favorable today. That’s because of improvements in treatment. 

People who live 5 years without relapse of AML are usually cured. Even people who have previously relapsed, but who then achieve a second complete remission and remain in it for 5 years are likely to be cured.

What are the survival rates for people with AML?

These are the facts according to statistics from the National Cancer Institute. However, it is important to understand that your actual survival rate varies greatly depending on the subtype of AML you have and other factors:

  • Overall, the 5-year survival rate for AML is about 25%

The 5-year survival rate varies slightly based on race and gender:

  • For white women, it is about 26%

  • For white men, it is about 22%

  • For black women, it is about 26%

  • For black men, it is about 24%

Other factors that affect your prognosis

The subtype of your AML is a very important factor in determining your prognosis, as some subtypes of AML have a much better outlook than others. Here is a list of other conditions and characteristics that affect your prognosis. They do not correspond to any specific subtypes of AML.

Your prognosis may be better if you have any of these traits:

  • Your leukemia cells have translocations between chromosomes 8 and 21 or between 15 and 17.

  • Your leukemia cells have an inversion of chromosome 16.

  • Your leukemia cells have changes in certain genes, such as mutations in the NPM1 gene.

  • You are younger than 60.

Your prognosis may be worse if you have any of these traits:

  • Part of chromosomes 5 or 7 is missing in your leukemia cells.

  • Your leukemia cells have complex changes involving many chromosomes.

  • Your leukemia cells have certain gene changes, such as mutations in the FLT3 gene.

  • You're older than 60.

  • Your white blood cell count is over 100,000 at the time of your diagnosis.

  • Your leukemia does not respond well to the initial treatment.

  • You have had a preleukemic condition or your AML developed after being treated for another cancer. 

  • You have an active blood infection.

  • The leukemia has reached the area around your brain and spinal cord.