Survival Rates and Outlook for Acute Myeloid Leukemia (AML)

• Advancements in cancer treatments and doctors' understanding of acute myeloid leukemia (AML) mean that more and more people survive the condition each year.
• The 5-year overall survival rate for AML is 29.5 percent, but children generally have a higher remission rate after initial treatment compared to adults.
• Factors such as age, AML subtype, and treatment response significantly influence survival rates, with treatment being less effective for individuals over 60.
AML is a type of cancer that affects the bone marrow and blood. It's known by various names, including acute myelogenous leukemia and acute non-lymphocytic leukemia. AML is one of the most common leukemia types in adults.
Doctors call AML ' acute ' because the condition can progress rapidly. The term ' leukemia ' refers to cancers of the bone marrow and blood cells. The word myeloid, or myelogenous, refers to the cell type it affects.
Myeloid cells are precursors to other blood cells. Usually, these cells go on to develop into red blood cells (RBCs), platelets, and special types of white blood cells (WBCs). But in AML, they aren't able to develop normally.
When a person has AML, their myeloid cells mutate and form leukemic blasts. These cells don't function as normal cells do. They can keep the body from making normal, healthy cells.
Eventually, a person will start to lack RBCs that carry oxygen, platelets that prevent easy bleeding, and WBCs that protect the body from diseases. That's because their body is too busy making the leukemic blast cells.
The result can be deadly. However, for many people, AML is a treatable disease.
What are the survival rates for AML?
Every year, doctors diagnose an estimated 20,240 cases of AML in the United States. An estimated 11,400 deaths occur annually because of the disease.
Most people with AML receive chemotherapy treatments. These medications rapidly kill dividing cells, such as cancer cells. Chemotherapy can lead to remission, which means a person doesn't have symptoms of the disease and their blood cell counts are in a normal range.
According to the American Cancer Society (ACS), around 90 percent of people with an AML type known as acute promyelocytic leukemia (APL) will go into remission after 'induction' (first round) of chemo. For most other types of AML, the remission rate is around 67 percent.
People older than age 60 don't typically respond to treatment as well, with about half of them going into remission after induction.
Some people who go into remission stay in remission. Still, for many, AML can return over time.
The 5-year overall survival rate for AML is 29.5 percent, according to the National Cancer Institute (NCI). This means that an estimated 29.5 percent of people in America living with AML are still living 5 years after their diagnosis.
Children with AML
In general, children with AML are seen as lower risk than adults. Around 85 to 90 percent of children with AML will go into remission after induction therapy. AML will return in some cases.
The 5-year-survival-rate for children with AML is 65 to 70 percent.
What factors influence survival rate?
The outlook and prognosis for acute myeloid leukemia varies widely. Doctors consider many factors when giving someone a prognosis, such as the person's age or type of AML.
Much of the outlook is based on the outcomes and analysis of:
blood tests
imaging studies
cerebrospinal fluid (CSF) examinations
bone marrow biopsies
Some people with a poor prognosis live many more years than a doctor predicts, while others may not live as long.
What effect does age have on survival rate?
The median age of a person diagnosed with acute myeloid leukemia is 68 years old.
Age can be a major factor in determining AML treatment response. Doctors know that survival rates for those diagnosed with AML are more promising for people under age 60.
This could be for a number of reasons. Some people older than 60 may have chronic conditions or other health issues. This can make it difficult for their bodies to handle the strong chemotherapy medications and other cancer treatments associated with acute myeloid leukemia.
Moreover, many older adults with AML don't receive treatment for the condition.
A 2018 study found that 25 percent of adults diagnosed with AML did not get chemotherapy. Researchers noted that older age and having other major health problems decreased the likelihood of receiving chemo, as well as being female and having a lower income status. A 2015 study found that only 40 percent of people ages 66 and up received chemotherapy within 3 months of diagnosis.
Research published in 2020 suggests that despite the differences in treatment response among different age groups (or cohorts), overall 5-year survival rates are improving for all groups. However, researchers note that those rates drop off significantly as people with the condition get older.
Age 5-year survival rate
Children under the age of 14 65 to 70 percent
Ages 15 to 34 52 percent
Ages 35 to 54 37 percent
Ages 55 to 64 20 percent
Ages 65 to 74 9 percent
What effect does AML type have on survival rate?
Doctors often classify the different subtypes of AML, because the subtype affects a person's health outlook and the best course of treatment. This is because AML does not follow the stages of other cancers with tumors. The various types may require different forms of treatment and may affect the potential survival rate.
According to the French-American-British classification of AML, subtypes include:
M0. Undifferentiated acute myeloblastic leukemia
M1. Acute myeloblastic leukemia with minimal maturation
M2. Acute myeloblastic leukemia with maturation
M3. Acute promyelocytic leukemia (APL)
M4. Acute myelomonocytic leukemia
M4 eos. Acute myelomonocytic leukemia with eosinophilia
M5. Acute monocytic leukemia
M6. Acute erythroid leukemia
M7. Acute megakaryoblastic leukemia
Your oncologist will tell you what subtype you have.
What effect does treatment response have on survival rate?
Treatment works better for some people than others. If a person receives chemotherapy treatments and their cancer doesn't come back within 5 years, they're usually considered 'cured.'
If a person's cancer comes back or doesn't respond to treatments at all, their treatment outcome isn't as favorable.
Some people also cannot tolerate treatment and thus do not get the full benefit if it's stopped early or has to be modified. Treatment depends on the person's age and overall health, which also affects survival.

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