Acute Myeloid Leukemia (AML) Prognosis

Survival Outcomes Based on Disease-related Risk Factors

Overall survival varies significantly by cytogenetic risk group (CALGB criteria)1 and by type of AML2

AHD-AML, AML with antecedent hematological disease; t-AML, therapy-related AML.

In this analysis, patient prognosis is determined by cytogenetic risk group and type of AML:

  • Patients with adverse risk cytogenetics have worse survival outcomes compared to intermediate or favorable risk1
  • Patients with secondary AML have worse survival outcomes compared to therapy-related or de novo AML2

Survival Rates Vary by Age

5-year AML Survival Rates3

Age Cohort Survival Rate
<60 Up to 50%
≥60 3% to 8%

Nearly 60% of newly diagnosed patients with AML are 65 or older; however, prognosis for these patients remains poor.4 Even with current treatments, up to 70% of patients 65 years or older die of their disease within 1 year of diagnosis.5 AML is particularly devastating in the older patient population considering most people living in the Western world can expect to live well into their eighth decade.6

There are many reasons for poorer outcomes in older adults6:

  • Older patients are often frail and have comorbidities that make them unable to tolerate, or ineligible for, intensive chemotherapy
  • From a clinical standpoint, elderly patients are more likely to have received previous treatment, radiation, or have had a prior hematologic disease
  • Elderly patients are more likely to have multiple chromosomal abnormalities than younger patients

References: 1. Byrd JC, Mrózek K, Dodge RK, et al. Pretreatment cytogenetic abnormalities are predictive of induction success, cumulative incidence of relapse, and overall survival in adult patients with de novo acute myeloid leukemia: results from Cancer and Leukemia Group B (CALGB 8461). Blood. 2002;110(13):4325-4336. 2. Hulegårdh E, Nilsson C, Lazarevic V, et al. Characterization and prognostic features of secondary acute myeloid leukemia in a population-based setting: a report from the Swedish Acute Leukemia Registry. Am J Hematol. 2015;90(3):208-214. 3. Oran B, Weisdorf DJ. Survival for older patients with acute myeloid leukemia: a population-based study. Haematologica. 2012;97(12):1916-1924. 4. Cancer Stat Facts: Leukemia - Acute Myeloid Leukemia (AML). National Cancer Institute website. Accessed April 22, 2021. 5. De Kouchkovsky I, Abdul-Hay M. Acute myeloid leukemia: a comprehensive review and 2016 update. Blood Cancer J. 2016;6(7):e441. 6. Almeida AM, Ramos F. Acute myeloid leukemia in the older adults. Leuk Res Rep. 2016;6:1-7.