The prognosis depends on the type of leukemia, the extent of the disease, age of the patient, and the general condition of the patient. Some patients can go into complete remission. The average five-year survival rate of leukemia is 60-65%.
The survival rate of acute lymphoblastic leukemia (ALL) depends on the age of the patient and the response to chemotherapy. The average five-year survival in ALL is 68.1%. Survival rates continue to improve with newer and improved treatment modalities. The prognosis is better in those under 35 years of age, and children have the best prognosis. The highest death rates due to ALL is seen in those over 65 years of age. 40% of adults can be cured of ALL. The average five-year survival rate of American children with ALL is around 85%. Children are considered cured of ALL if they are in remission (symptom-free period) for more than five years after treatment.
Around 98% of children with ALL achieve remission. Remission means a child doesn’t have any signs or symptoms of the condition, and blood cell counts are within normal limits.
Patients with leukemia may ultimately die due to multiple infections (bacterial, fungal, and viral), severe nutritional deficiencies, and failure of multiple organ systems. Patients can also face complications due to the treatment, which can sometimes be life-threatening.
What is leukemia?
Leukemia is a cancer of the blood cells and bone marrow. There is an abnormally high production of white bloodless (cells that fight infection and provide immunity), which are unable to mature properly leading to the symptoms in leukemia.
Based on the origin, they can be divided into two broad types, namely, myeloid and lymphoid:
- Myeloid leukemia (myelogenous leukemia) arises from the myeloid line of the white blood cells. Normal myeloid cells undergo differentiation to form leukocytes.
- Lymphoid leukemia (lymphoid or lymphoblastic leukemia) arises from the lymphoid line of cells in the bone marrow.
Based on how fast it progresses, it is divided into acute and chronic leukemia:
What are the types of leukemia?
Acute lymphocytic leukemia (ALL):
- It progresses rapidly and spreads to other organ systems through the blood.
- It mostly occurs in children and above the age of 45 years.
Acute myeloid leukemia (AML):
- It is the second most common leukemia in adults and rapidly progressive.
- It is commonly seen in adults aged over 55-60 years.
- The myeloid cells mutate, forming defective cells, and prevent the formation of normal, healthy blood cells (white, red, and platelets).
Chronic lymphocytic leukemia (CLL):
- It is slow-growing cancer that begins in the lymphocyte cells present in the bone marrow.
- There is abnormally high multiplication of the lymphocyte cells that are immature and do not function properly.
Chronic myeloid leukemia (CML):
- It is associated with a chromosomal abnormality known as the Philadelphia chromosome.
- The upper part of chromosome 22 breaks off and attaches to the lower part of chromosome 9. The upper part of chromosome 9 attaches to the lower part of chromosome 22.
Hairy cell leukemia (HCL):
- It is a rare subtype of CLL that progresses slowly.
- The bone marrow produces a high number of B-Cells, a type of white blood cell that fights against infection-causing a decrease in healthy blood cells.
Myelodysplastic syndromes (MDS):
A group of closely related diseases in which the bone marrow produces very few healthy, functioning red blood cells, white blood cells, platelets, or any combination of the three.
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What are the signs and symptoms?
Some common signs and symptoms include:
How is leukemia treated?
Treatment involves one or a combination of the following treatment modalities:
- Chemotherapy: Single drug or a combination of different drugs to kill cancer cells.
- Radiation therapy: Radiation is used to damage, kill, and inhibit the growth of cancer cells.
- Bone marrow transplant: Diseased bone marrow is replaced with healthy bone marrow from the patient (autologous transplantation) or a donor (allologous transplantation).
- Immunotherapy: They modulate the body’s immune system attacking cancer cells.
- Treatment of pain, anemia, and infections
- Nutritional supplementation
- Palliative care in untreatable cases: Interdisciplinary medical care to improve quality of life, reduce pain, and suffering.
- Treatment of side effects of cancer treatment such as nausea, vomiting, hair loss, and inflammation of the skin.
- Psychological support
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Purinethol (mercaptopurine)Purinethol (mercaptopurine) is used to slow the growth of cancer cells. Purinethol is also used to treat certain types of leukemia. Common side effects of Purinethol include nausea, vomiting, diarrhea, loss of appetite, itching or skin rash, or darkened skin color. Temporary hair loss may also occur.
Treanda (bendamustine hydrochloride) InjectionTreanda (bendamustine hydrochloride) injection is an antineoplastic (anticancer) medication used to treat chronic lymphocytic leukemia. Treanda is also used to treat indolent B-cell non-Hodgkin lymphoma after other medications have been tried without successful treatment of this condition. Common side effects of Treanda include nausea, vomiting, diarrhea, tiredness, weakness, mouth sores, constipation, upset stomach, swelling in your hands or feet, headache, dizziness, drowsiness, loss of appetite, weight loss, and mild skin rash.
Venclexta (venetoclax)Venclexta is a prescription medicine used to treat adults with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) in combination with azacitidine, or decitabine, or low-dose cytarabine to treat adults with newly-diagnosed acute myeloid leukemia (AML) who are 75 years of age or older, or have other medical conditions that prevent the use of standard chemotherapy.
Zydelig (idelalisib)Zydelig is a prescription medication used to treat relapsed forms of chronic lymphocytic leukemia (CLL), follicular B-cell non- Hodgkin lymphoma (FL), and small lymphocytic lymphoma (SLL). Zydelig is not indicated and is not recommended as a first-line treatment. Serious side effects of Zydelig include fatal and/or serious hepatotoxicity, severe diarrhea, pneumonitis, infections, and intestinal perforation.