Prognosis and Survival in Acute Myelogenous Leukemia

Abstract

Progress in understanding the prognosis and survival in acute myelogenous leukemia (AML) has been dramatic over the last few decades. Traditionally, clinical risk factors such as age and performance status have been the main prognostic factors in AML. However, recent advances in cytogenetic studies and molecular markers in AML have revolutionized our approach to this disease. These have changed our understanding of AML as a heterogeneous group of diseases rather than a single disease, provided greater insight not only in understanding disease biology but also into predicting response to therapy and helped in the development of risk stratification-based treatment approach. In 2010, there are about 12,330 new cases in the United States which represent about 0.8% and 29% of all new cancer and leukemia cases respectively. With about 8,950 estimated deaths related to AML, this represents about 1.6% of cancer related deaths in 2010. (American Cancer Society, 2010) Although there has been some improvement in survival for AML patients over the last few decades, mainly in younger age groups as shown in figure 1, AML long term survival is still a big challenge. In the United States, data from Surveillance Epidemiology and End Results (SEER) dataset for 2001 to 2007 showed 5-year overall survival (OS) of 22.6% for all AML patients. There is still a lot to be done especially in the oldest age group (>65 years), that is showing a dismal 5-year OS of less than 5%, See Figure 2. This is of particular concern as more than half of the patients diagnosed in 2000-2004 were over 65 years old. (Howlader et al., 2011).