Acute myeloid leukemia, also known as acute myelogenous leukemia or AML, is a form of cancer affecting the bone marrow. The outlook, or acute myeloid leukemia prognosis, depends on a number of factors. These include the type of acute myeloid leukemia, the person's age, and whether there is a history of a previous blood disorder. Cancers which are recurring, which have been treated before, or which have spread generally have a worse prognosis. The outlook is also poorer if the person has received chemotherapy treatment for any cancer in the past.
In acute myeloid leukemia, cells in the bone marrow which would normally develop to form red blood cells, white blood cells or platelets may remain immature and may be produced in excess. Most often, it is the white blood cells which are affected but, in rarer types of this acute leukemia, many immature red cells or platelets may be produced. As the number of abnormal cells rises, they may enter the circulation, and there may be less room available in the bone marrow for normal blood cell production. The subsequent lack of normal blood cells leads to symptoms such as fatigue, breathlessness, bleeding and increased infections.
Acute myeloid leukemia is normally divided into several subtypes, each of which has a different effect on the overall acute myeloid leukemia prognosis. In certain subtypes, changes in the chromosomes inside cells may be associated with a better or worse outlook. Some patients who have had a bone marrow disorder called myelodysplasia, and who go on to develop AML, tend to have a poorer prognosis. Patients with extremely high levels of white blood cells tend to do less well as do those whose leukemia does not respond well to treatment with chemotherapy.
Older people have a less favorable acute myeloid leukemia prognosis, often because other medical conditions can leave them less able to cope with intensive chemotherapy treatments. With increasing age, it is also more likely that people will have already had a blood disorder, making the outlook less positive. Acute myeloid leukemia which arises after a previous cancer was treated with chemotherapy is associated with a worse prognosis. This is what is known as a secondary leukemia, which develops after chemotherapy damages cells in the bone marrow, and it can be harder to treat.
In younger adults, about half are expected to remain alive five years after diagnosis, and around a third may be considered cured. For older patients the outlook is not as good, with a less than 10 percent chance of surviving for more than five years. The acute myeloid leukemia prognosis for children is much better than it is for adults, with around two-thirds surviving for longer than five years.