Survival rate of acute myeloid leukemia among the elderly population
Acute Myeloid Leukemia (AML) is a type of cancer that affects a person's bone marrow and blood cells, and the survival rates and prognosis can vary significantly depending on the individual's age.
Age and Survival Rates
The estimated 5-year survival rate for children under 20 with AML is around 65–70%, while for adults aged 20 and older, the rate drops to approximately 28%. For older adults aged 60 and above, the survival rate decreases further to around 20–30%, and in some cases, it can drop as low as 3–8%.
The median overall survival (life expectancy) for elderly AML patients is poor, with a recent study showing a median overall survival of 19.3 months for fit elderly patients treated with venetoclax-based therapy. The majority of elderly patients succumb within one year of diagnosis, mainly due to comorbidities, poorer tolerance to intensive chemotherapy, and more aggressive disease biology.
In contrast, children and younger adults with AML have significantly better survival rates, with better general health, higher tolerance for aggressive treatment, and frequently more favorable disease subtypes.
| Age Group | Approximate 5-Year Survival Rate | Median Overall Survival (months) | Notes | |-------------------|---------------------------------|----------------------------------|-----------------------------------------| | Children (<20) | 65–70% | Not specifically provided | Favorable outcomes with intensive treatment | | Adults (20+) | ~28% | Not specifically provided | Survival drops significantly after 20 | | Older adults (60+) | 20–30% (sometimes as low as 3–8%) | ~19 (fit elderly with novel therapies), generally <12 months for many | Poorer prognosis, higher treatment resistance and comorbidities |
Factors Affecting Prognosis
Several factors can influence the prognosis of AML patients, including the person's age, the severity of the disease, genetic or chromosomal risk factors, and the type and dosage of drugs used for consolidation treatment. People with genetic conditions, such as Down syndrome or neurofibromatosis type 1, may also have an increased risk of developing AML.
In addition, smoking, exposure to certain chemicals like benzene and formaldehyde, and radiation can increase the risk of developing AML. Comorbidities, poorer baseline health status, and higher incidence of complications can also negatively impact the prognosis of older adults with AML.
Treatment Options
Treatment for AML typically involves chemotherapy, with consolidation treatment recommended following successful chemotherapy to kill any remaining cancer cells in the body. A bone marrow biopsy is used to check for cancerous cells in AML patients.
The American Society of Hematology recommends opting for treatment over supportive care wherever possible. Some people with AML may choose supportive care instead of treatment to manage the cancer, but this option is generally not recommended due to the potential for the disease to progress rapidly.
Advancements in treatments like venetoclax show promise but have not yet bridged the survival gap between older adults and younger populations with AML. Further research is needed to improve outcomes for patients of all ages.
- Older leukemia patients often face poorer survival rates compared to children and younger adults due to factors such as aging, comorbidities, and more aggressive disease biology.
- Other leukemias, like Down syndrome or neurofibromatosis type 1, may increase one's risk of developing AML.
- Science and medical advancements, such as the use of venetoclax, have shown promise in improving AML treatment outcomes, but the survival gap between older adults and younger populations remains.
- Caregivers and those caring for AML patients should be aware of the importance of health-and-wellness, cancer prevention, and early detection of medical-conditions, as they can significantly impact a patient's prognosis.
