Leukemia Survival Rate

What Is Leukemia?

Understanding where a malignant neoplasm originates is the key to recognizing possible treatment options and getting clarity regarding prognosis. The nature of leukemia, where it originates, and its types can help us understand more about the disease.

Leukemia is a neoplasm found in the blood. Usually called blood cancer, leukemia is triggered by an increase in white blood cells in the body produced by bone marrow and lymphatic tissues. These white blood cells don't perform as well as the others, often overwhelming the red blood cells and platelets needed by the body [¹].

The diagnosis and treatment of leukemia depend on the staging and multiple other factors such as family history, health, age, and more. The ICD 10 code for leukemia, C95.9, can help you connect with medical professionals and get more information on the same.

Types of Leukemia

A simple classification of leukemia categorizes it as a malignant neoplasm of the blood. Although all kinds of leukemia are impacted by an increase in white blood cells, different categories lead to the following sub-types;

• Chronic lymphocytic leukemia
• Acute myeloid leukemia
• Chronic myeloid leukemia
• Acute lymphocytic leukemia

The categories are created through;

Location

One of the categorizations of the sub-types is possible through the location of the cancer. It may reveal itself in one of two ways [²];

• Lymphocytic Leukemia: This kind of leukemia usually develops in white blood cells called lymphocytes within the bone marrow.
• Myeloid Leukemia: This type starts in the white blood cells mentioned above, red blood cells, and platelets.

Progression

Another kind of classification can be made based on progression. This is related to how fast leukemia develops.

• Acute Leukemia: This type develops much more aggressively, whereby dysfunctional white blood cells crowd the bone marrow. Over time, the bone marrow fails to create enough functional cells for the body.
• Chronic Leukemia: This type develops slowly. The white blood cells produced here are much more functional, yet symptoms are less noticeable, and treatment options are more complicated.

What Are the Signs and Symptoms of Leukemia?

Leukemia may produce noticeable signs and symptoms before it progresses to carcinomatosis. These include the following [³];

• Bone pain, bleeding, bruising, and red spots on the skin
• Persistent fatigue, weight loss, and fever without an obvious cause
• Susceptibility to infection
• Swelling of lymph nodes, liver, or spleen

These symptoms are much broader and can be a result of other conditions. It is best to speak to a medical professional and avoid unnecessary concern until you receive a diagnosis.

Leukemia Diagnosis and Staging

A diagnosis and staging of neoplasms can lead to better management and understanding of the disease. The same is true for leukemia. Diagnosis and subsequent staging are essential steps before discovering prognosis and treatment options.

How is Leukemia Diagnosed?

The diagnosis of leukemia is usually performed in several stages. These include the following [⁴];

• Step 1: Complete Blood Count (CBC)

A doctor might ask you to get a complete blood count, a blood test that provides a snapshot of your white blood cell, red blood cell, and platelet count. It can also tell you more details, such as the concentration of hemoglobin or hematocrit in your blood.

• Step 2: Additional Procedures

If your CBC shows abnormal results, a doctor might recommend some further procedures, such as a bone marrow aspiration or biopsy that extracts bone marrow from the hip bone, for further testing. It also includes other more advanced procedures such as FISH, flow cytometry, or a spinal tap for lab testing that reveals the presence of cancer in the blood.

Leukemia Staging

Depending on the type of leukemia, staging may differ. However, most leukemia staging depends on how many cancerous cells exist in the body. Tests may differ based on the nature of leukemia and its spread.

Staging for Acute Lymphocytic Leukemia (ALL)

The staging for children and adults may differ. While staging for children is based on risk, adults receive stages according to diagnosis [⁵].

• Children

Low Risk: This is assigned to children under 10 years with less than 50,000 WBC count.

High Risk: This is assigned to children over 10 years with over 50,000 WBC counts.

• Adults

Untreated: This is when the diagnosis is fairly recent, and treatment has not begun.

Remission: This is assigned to people receiving treatment and presenting a normal WBC count, no symptoms, and fewer cancerous cells in the body.

Recurrent: If cancer comes back, adults with leukemia enter this stage. More testing and treatment are required.

Staging for Acute Myelogenous Leukemia (AML)

This includes subtypes from M0 to M7 based on where leukemia has originated. For types M0 to M5, cancer begins in the WBCs. However, M6 originates in RBCs and M7 in the platelets.

M1 to M4 subtypes have a better prognosis than M0, M6, and M7 [⁶].

Staging for Chronic Lymphocytic Leukemia (CLL)

This type grows more slowly and is staged through abnormal WBCs. In stage 0, the abnormal WBCs may be high in the count, but other blood counts aren't affected. Lymph nodes might be affected by stage 1, and by stage 2, the liver and spleen might have become enlarged [⁷].

By stage 3, other blood cells begin to get affected, and the RBCs drop. In the final stage, platelets are also affected, and the blood might not be able to clot normally.

Staging for Chronic Myeloid Leukemia (CML)

In CML, staging is done according to the production of blast cells (extra WBCs). The more blast cells, the more the disease has progressed. This progression is divided into chronic, accelerated, and blastic phases [⁸].

Leukemia Survival Rate

The prognosis for leukemia usually considers two separate metrics: survival rate and quality of life (QOL). Doctors and researchers typically define survival rate in terms of the five-year survival rate, which indicates the percentage of patients who are alive five years after their diagnosis.

The survival rate for leukemia is highly dependent on the stage of the disease, including tumor size and extent of metastasis, as well as on the patient's underlying health status. In general, leukemia cancers caught at earlier stages (stage 0/in situ, stage 1) have a better outlook.

If cancer has metastasized, treatment is more difficult, but in any case, it is important to maintain hope. It is important to understand that survival statistics represent averages - they should not be taken as prescriptive determinations of your future outcome.

What is the Survival Rate for Leukemia?

Survival rates for all kinds of neoplasms follow a similar vocabulary. A mean survival rate is usually provided as a 5-year relative survival. Loosely translated, this shows the number of people who have survived up to 5 years after diagnosis. Further classification can also include disease-free and long-term survival.

Here are some general statistics to note [⁹];

• AML: 27.6% 5-year mean survival rate
• ALL: 68.8% 5-year mean survival rate
• CLL: 85.4% 5-year mean survival rate
• CML: 67.8% 5-year mean survival rate

Your age, medical history, underlying conditions, activity, level, genetics, cancer type, and reaction to cancer treatment and medication can all affect your final prognosis. The prognosis factors for different types of leukemia are listed below;

Prognosis for ALL

Multiple factors should be considered when it comes to the prognosis for ALL, as listed below [¹⁰].

1. Age

Age is the most important factor. Younger patients with an ALL diagnosis tend to receive a better prognosis than older ones. Older patients might have certain chromosome abnormalities or underlying medical conditions that can affect treatment.

2. WBC Counts

The WBC counts at the time of diagnosis can also affect prognosis. People with a lower WBC count tend to receive a better prognosis. These counts differ according to sub-types.

3. Genetics

Certain genetic or chromosome characteristics can also impact the outcomes of treatment. For example, a translocation between chromosomes 4 and 11 might lead to a poorer prognosis. Yet, a translocation between chromosomes 12 and 21 provides a better prognosis. There are many other factors that a medical professional can list for you.

4. Response to Treatment

How far the disease progresses, even after treatment, will impact prognosis. People who enter remission early are much more likely to receive a better prognosis than others.

Prognosis for AML

For AML, the prognosis is usually affected by chromosome abnormalities and relevant factors. These include [¹¹];

1. Age

Much like ALL, AML also provides people over 60 years with less favorable outcomes. Underlying conditions and chromosome abnormalities make it harder for older people to undergo aggressive therapy.

2. WBC Count

People with a WBC count that exceeds 100,000 mm3 may receive a poorer prognosis.

3. Medical History

People who have been diagnosed with another cancer or blood disorder in the past may receive a poorer prognosis.

4. Health

People who are active and healthy with no signs of blood infection have a great chance of survival.

5. Response to Treatment

How fast the body responds to treatment and how quickly remission is achieved also makes a difference.

6. Genetics

Genetics has a major role to play in prognosis. Chromosomal abnormalities such as those listed above can lead a person to a better prognosis or away from it. Moreover, genetic mutations can also affect prognosis. Similarly, treatment options that target these mutations can achieve positive results.

Prognosis for CLL

Some of the factors that can impact CLL are similar to others. They can include [¹²];

• Age: Older People might receive a poorer prognosis.
• Specific translocation or other characteristics of chromosomes.
• Bone marrow characteristics.
• Blood characteristics.
• Reaction to treatment.
• Genetic markers.

Prognosis for CML

In the case of CML, it might be more complicated to understand the prognosis and relevant factors that affect it. This is because the staging process for the disease is also different. Multiple models have been developed by people in the past to make it easy for people to understand their long-term survival.

Survival probabilities change according to the following factors [¹³];

1. Staging

The staging and diagnosis you receive might impact the prognosis. For example, people who are in the accelerated or blast phase of the disease have poorer survival probabilities than others. This is true for all kinds of neoplasms.

2. Spread

The spread of the disease and its effect can also impact prognosis. For example, people with an enlarged spleen or impacted bones due to CML can receive a poor prognosis.

3. Blood

The count of platelets, WBC, red blood cells, blood composition, and other characteristics can increase or decrease your survival probability.

4. Age

Age also plays an important role, and the older the patient, the less response is received to treatment.

5. Genetics

Genetics and chromosomes can also affect prognosis, impacting CML cells and relevant changes.

Leukemia Treatment Options

Multiple treatment routes exist for leukemia. These include;

• Chemotherapy: This is the most popular treatment type and uses drugs to target leukemia cells. These drugs can be intravenous or consumed in the form of pills. Often, specific drugs are also used to target particular cancerous cells.
• Radiation: Radiation normally involves high-energy beams targeted to one specific region. This can also impact the cancerous cells and help them shrink.
• Bone Marrow Transplants: This involves targeting leukemia-producing WBCs through radiation, eliminating them, and replacing them through a bone marrow transplant with healthy stem cells.
• Immunotherapy: Since cancer can disguise itself against the body's fighting mechanism, this therapy allows the body to be able to identify and fight against the cancer.

These treatments may be limited. This is where clinical trials can step in, allowing you to try a new cancer treatment for better results. However, it is recommended you discuss all options with your doctor first.

Conclusion

Takeaway

A diagnosis of leukemia might be devastating, but treatment is possible. Advancements in drugs and modern technology provide many more dynamic solutions than before. Discuss all your concerns with your doctor before choosing a treatment plan.