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Prognosis of leukemia

Acute leukemia

With today's potent chemotherapy, about 3/4 of adult patients under 60 years reach complete hematological remission (CHR). Of these, 40–50% are alive after 3 years, most in CHR, some with recurrence, or in second or later remission. The chemotherapy's ability to prolong patient survival is similar to the time these patients live in CHR. The prognosis for patients over 60 years is poorer even with optimal treatment.

Chronic leukemia

The median survival for chronic myeloid leukemia from the time of diagnosis with modern tyrokinase inhibitor treatment is now calculated to be > 10 years.

Allogeneic stem cell transplantation can cure the disease in those with a suitable donor, but the risk for fatal or bothersome side effects is so great that this treatment is rarely used, as long as the disease responds well to tyrosine kinase inhibitors. Additional cytogenetic changes in the Ph+ (BCR-ABL positive) clone and degree of response to tyrosine kinase inhibitors at a given point in time, is of prognostic importance.

For chronic lymphatic leukemia, the bone marrow is always infiltrated with leukemic cells, but the growth pattern can vary. This is also significant for the prognosis. Infiltration with diffuse growth patterns is associated with poorer infiltration with a spotted pattern.

The lymphocyte doubling time is the time used until the number of lymphocytes in the blood is doubled in an untreated patient, and is another parameter which can give important information about prognosis. In about half of the patients, the lymphocyte doubling time is very long (5-6 years), and the life expectancy for these patients is good. Lymphocyte doubling time less than 12 months correlates with rapid progression and short survival.

 

 

Five-year relative survival of patients with leukemia, in percent, during the diagnosis period 1974–2013.

Source: Cancer Registry of Norway

 

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