The 5-year survival rate of patients with AML is 31.9% (based on US data, 2014-2020).[5]National Cancer Institute. Cancer stat facts: leukemia - acute myeloid leukemia (AML) [internet publication].
https://seer.cancer.gov/statfacts/html/amyl.html
Younger (<60 years of age) and healthier patients
The overall cure rate for patients between 18 and 60 years of age with AML is 35% to 40%.[144]Döhner H, Weisdorf DJ, Bloomfield CD. Acute myeloid leukemia. N Engl J Med. 2015 Sep 17;373(12):1136-52.
http://www.ncbi.nlm.nih.gov/pubmed/26376137?tool=bestpractice.com
However, cure rate will vary depending on the presence or absence of certain prognostic markers, including cytogenetic abnormalities and genetic mutations.[24]Döhner H, Wei AH, Appelbaum FR, et al. Diagnosis and management of AML in adults: 2022 recommendations from an international expert panel on behalf of the ELN. Blood. 2022 Sep 22;140(12):1345-77.
https://www.doi.org/10.1182/blood.2022016867
http://www.ncbi.nlm.nih.gov/pubmed/35797463?tool=bestpractice.com
[114]Breems DA, Van Putten WL, Huijgens PC, et al. Prognostic index for adult patients with acute myeloid leukemia in first relapse. J Clin Oncol. 2005 Mar 20;23(9):1969-78.
https://ascopubs.org/doi/10.1200/JCO.2005.06.027
http://www.ncbi.nlm.nih.gov/pubmed/15632409?tool=bestpractice.com
[145]Cheson BD, Bennett JM, Kopecky KJ, et al. Revised recommendations of the International Working Group for Diagnosis, Standardization of Response Criteria, Treatment Outcomes, and Reporting Standards for Therapeutic Trials in Acute Myeloid Leukemia. J Clin Oncol. 2003 Dec 15;21(24):4642-9.
http://www.ncbi.nlm.nih.gov/pubmed/14673054?tool=bestpractice.com
Population-based statistics from the US Surveillance, Epidemiology, and End Results Programme (2014-2020) report 5-year relative (from the time of diagnosis) of 63.7% among patients aged <50 years.[146]National Cancer Institute. Surveillance, Epidemiology, and End Results Program. SEER*Explorer [internet publication].
https://seer.cancer.gov/explorer
Older (≥60 years of age) patients
The overall outlook for older patients is poorer than that of younger patients. This is based on the higher prevalence of unfavourable cytogenetics, antecedent myelodysplasia in older patients, a higher incidence of multi-drug resistance, and an increased frequency of coexistent medical conditions that affect the ability to tolerate intensive treatment.[147]Leith CP, Kopecky KJ, Godwin J, et al. Acute myeloid leukemia in the elderly: assessment of multidrug resistance (MDR1) and cytogenetics distinguishes biologic subgroups with remarkably distinct responses to standard chemotherapy. A Southwest Oncology Group study. Blood. 1997 May 1;89(9):3323-9.
https://www.sciencedirect.com/science/article/pii/S0006497120583468
http://www.ncbi.nlm.nih.gov/pubmed/9129038?tool=bestpractice.com
[148]Ossenkoppele G, Löwenberg B. How I treat the older patient with acute myeloid leukemia. Blood. 2015 Jan 29;125(5):767-74.
https://ashpublications.org/blood/article/125/5/767/34072/How-I-treat-the-older-patient-with-acute-myeloid
http://www.ncbi.nlm.nih.gov/pubmed/25515963?tool=bestpractice.com
Population-based statistics from the US Surveillance, Epidemiology, and End Results Programme (2014-2020) report 5-year relative survival from the time of diagnosis of:[146]National Cancer Institute. Surveillance, Epidemiology, and End Results Program. SEER*Explorer [internet publication].
https://seer.cancer.gov/explorer
Prognosis according to risk and age
For favourable-risk patients (according to the 2022 European LeukemiaNet [ELN] risk groups), 5-year overall survival is:[149]Rausch C, Rothenberg-Thurley M, Dufour A, et al. Validation and refinement of the 2022 European LeukemiaNet genetic risk stratification of acute myeloid leukemia. Leukemia. 11 Apr 2023 [Epub ahead of print].
https://www.doi.org/10.1038/s41375-023-01884-2
http://www.ncbi.nlm.nih.gov/pubmed/37041198?tool=bestpractice.com
For intermediate-risk patients (according to the 2022 ELN risk groups), 5-year overall survival is:[149]Rausch C, Rothenberg-Thurley M, Dufour A, et al. Validation and refinement of the 2022 European LeukemiaNet genetic risk stratification of acute myeloid leukemia. Leukemia. 11 Apr 2023 [Epub ahead of print].
https://www.doi.org/10.1038/s41375-023-01884-2
http://www.ncbi.nlm.nih.gov/pubmed/37041198?tool=bestpractice.com
For adverse-risk patients (according to the 2022 ELN risk groups), 5-year overall survival is:[149]Rausch C, Rothenberg-Thurley M, Dufour A, et al. Validation and refinement of the 2022 European LeukemiaNet genetic risk stratification of acute myeloid leukemia. Leukemia. 11 Apr 2023 [Epub ahead of print].
https://www.doi.org/10.1038/s41375-023-01884-2
http://www.ncbi.nlm.nih.gov/pubmed/37041198?tool=bestpractice.com
Acute promyelocytic leukaemia (APL)
The cure rates for APL with current treatment protocols exceed 80%.[150]Kelaidi C, Chevret S, De Botton S, et al. Improved outcome of acute promyelocytic leukemia with high WBC counts over the last 15 years: the European APL Group experience. J Clin Oncol. 2009 Jun 1;27(16):2668-76.
http://www.ncbi.nlm.nih.gov/pubmed/19414681?tool=bestpractice.com
The aim of current trials is to determine schedules that offer maximum cure rates with minimal toxicities.