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Can I Survive Acute Lymphocytic Leukemia? What Is My Prognosis?

A prognosis is a statement about the prospect of surviving and recovering from a disease. It may be difficult to ask, “Can I survive this?” But it’s a question on the minds of most people when they learn they have leukemia. Unfortunately, there isn’t an easy answer.

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, your doctor will look at what researchers have found out over many years about thousands of people with leukemia. When possible, your doctor will make a prediction, based on statistics from groups of people whose situations are most like yours.

If your cancer 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 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. 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 a disease. Survival rates are based on large groups of people. They cannot be used to predict what will happen to a particular person. No two people are exactly alike, and treatment and responses to treatment vary greatly.

A 5-year survival rate refers to people who live at least 5 years after they are diagnosed. The survival rate includes:

  • People free of disease

  • Those with few or no signs or symptoms of the disease

  • Patients undergoing treatment for the disease

Many people live much longer than 5 years after diagnosis. Current statistics available for 5-year rates are based on people diagnosed and first treated more than 5 years ago. It’s possible that the outlook could be more favorable today because of improvements in treatment. You may want to ask your doctor for the most up-to-date statistics. 

What are the 5-year survival rates for people with acute lymphocytic leukemia?

The Leukemia and Lymphoma Society reports the following about your chances of surviving acute lymphocytic leukemia (ALL):

  • Changes in treatment have dramatically improved the chances of surviving ALL. Between 1975 and 1977, the 5-year survival rate for all ages combined was 41%. Between 2003 and 2009, the rate increased to 69%. In children, specifically, survival rates have gone up from 58% to 92% during the same time periods.

Your chance of recovery depends on:

  • The type of ALL you have

  • How quickly your leukemia cells are growing

  • Your age and general health

  • How you respond to treatment

Other factors also predict your chances of recovery. Your doctor will  take the following into account when evaluating your treatment options:

  • In general, younger people with ALL tend to do better than older people.

  • People who have a lower white blood cell count at the time of diagnosis tend to have a better prognosis.

  • People who need a longer period of therapy to reach remission tend to have a worse prognosis.

  • A translocation in the leukemia cells between chromosomes 9 and 22, called the Philadelphia chromosome, predicts a worse prognosis. Other genetic translocations may predict a poorer outcome as well.