When people hear the word cancer, the first thing they want to know is their chance for survival. This is called a prognosis. The medical team on the case will factor in several points in order to come up with a prognosis. There are prognostic factors as well as predictive factors that help the team arrive at a prognosis. When the prognosis is reached, then the treatment can begin in earnest. Let’s take a look at what acute myelogenous leukemia is before we get to prognoses.
Also called acute myeloid leukemia or AML, this is a cancer of the bone and blood. Leukemia is cancer of the blood. Myeloid is the type of cell cancer destroys. Acute means the cancer progresses rapidly and should be treated immediately.
A person with AML doesn’t make normal blood cells. They myeloid cells morph into cancerous cells. These proliferate until no cells at all can make healthy viable cells. When this happens, no red blood cells will carry oxygen throughout the body, no platelets will make blood clot, and no white blood cells will fight off infections.
Because statistics are reached following studies of groups of people, it is difficult to see how something will affect individuals. However, due to advances in medical treatments, studies, and doctors’ understanding of the disease and their patients, it has been found that almost 70 percent of AML patients reach remission. Since AML strikes people over 60, it is expected that around 40 percent of people will live three or more years.
In order to live disease-free for five years or more, an allogeneic stem cell transplant is required. If the cancer has not reoccurred two years after the transplant, then the patient’s survival rate is almost 50 percent.
The majority of prognostic factors reside in the patient. Medical history, the type of cancer and what stage it has reached, what treatments have been discussed and the reaction to the treatments all combine to form a prognosis.
However, predictive factors narrow it down to specific treatment and its overall success with the specific disease.
People younger than 60 may be healthy enough to handle the chemotherapy and radiotherapy and their side effects. Additionally, chromosomal changes happen more frequently as people age. The survival rate is higher for those under 60.
Good risk and bad risk chromosomal changes influence the predictive factors in acute myeloid leukemia. Chromosomes move about inside themselves, transferring and adding to chromosomes. Good and intermediate risk factors are figured into the predictive factors.
About half the people with AML have the NPM1 gene. CEBPA gene mutation is a favorable predictive factor. Less than happy mutations are the FLT3 gene, which about 30 percent of patients have. Too much of the ERG gene in patients is a less happy mutation.
The most desired results of chemotherapy is in the induction phase. If it only takes four weeks to reach remission, then the prognosis is good. In the consolidation phase, or treating the condition to keep it from recurring, if the blasts cannot be seen using the most sensitive testing, then the prognosis is good.
The presence of certain things in the body mean they have to be eliminated for the prognosis to be favorable. Things like previous cancer, a leukemia relapse, infections, leukemia in the brain or the spine, or previous blood diseases all combine to create an unfavorable prognosis.
Keeping in mind that statistics are based on studies of groups of people, and keeping in mind that medical advances have made inroads on cancers, and keeping in mind that individual circumstances will color the outcome, then the usually accepted survival rate of 27 percent could look better. This is a viable statement, considering the experts reassess the survival rates every five years. So of the almost 11,000 estimated sufferers predicted for this year alone, if the five years' assessment period is here or has passed, then it is logical to think that the majority of those almost 11,000 will survive.
Patient questions about survival rates should be addressed to their medical team, due to the fact that they will have more up-to-date studies and information at hand.