What is the prognosis of Leukemia?

The term prognosis indicates the chance of cure or recurrence (return) of a particular type of cancer. It is important for the patient and the family as it helps them understand the possible outcome, what the future holds and thus, handle the disease and live with it better.  
Factors that determine the prognosis (chances of cure and risk for recurrence) of leukemia include:

• Type of the cancer.
• Stage of cancer (extent of involvement of the organ and spread to other parts of the body).
• Grade of tumor (how abnormal or malign the cancer cells are and how quickly the cells grow and spread).
• Patient factors such as age, general health and response to treatment.
• Cytogenetics:  certain chromosomal aberration play an important role in predicting the progress of  leukemia

The five-year survival rate is an important parameter that is determined while considering the prognosis. Survival rates of cancer indicate the proportion of people with a certain type and stage of cancer who live for a specific period of time after their diagnosis. The five-year survival rate indicates the percentage of people with the disease who are still alive five years after diagnosis (factors such as signs or symptoms of cancer, presence or absence of disease and treatment are not considered).

Prognosis of ALL

Prognosis of ALL in children is good: more than 95% of children attain remission. Prognosis or response to treatment is better in young children (ages 1 - 9 years) than in infants and children older than 10 years of age. Good response to treatment is an indicator of a good prognosis regardless of the risk category of leukemia. Prognosis of adults with ALL as compared with children is not quite favourable even if they have the same ALL genes (cytogenetic or chromosomal aberration). Full remission with standard treatment is achieved in 60 - 80% of adults and about 40% survive beyond 2 years with the help of aggressive treatments. Long-term survival rates are better in younger adults as compared with older adults with ALL.

Prognosis of Acute Myeloid Leukemia (AML)

Treatment for AML can control the disease for  a long period of time and sometimes, even cure it. The average 5-year survival rate of acute myeloid leukemia (AML) is about 20%. Survival is better in adults below 65 years (about 33%) as compared with adults above 65 years (about 4%). Based on the risk category according to cytogenetic, the 5-year survival rate of ALL is as follows:

Risk category     5-year survival rate
Good                      70%
Intermediate      48%
Poor                       15%

Prognosis of Chronic Lymphocytic Leukemia (CLL)

Prognosis of CLL is varied; most patients have been known to be alive 5 to 10 years after diagnosis whereas some may die within 2-3 years of diagnosis. The average five-year relative CLL survival rate is about 70%. Median life expectancy of patients with CLL based on the risk category is as follows:

• Low-risk group: 14+ years.
• Intermediate risk group: 8 years.
• High–risk group: 4 years.

Prognosis of Chronic Myeloid Leukemia (CML)

Prognosis of CML patients has improved considerably due to advances in treatment (such as bone marrow transplant and interferon) and better diagnostic techniques. This has improved the median survival rate from 3 years to 5 years and the 5-year survival rate from less than 20% to 50-60%.