Survival Rate and Prognosis for Acute Lymphoblastic Leukemia
What Is Acute Lymphoblastic Leukemia?
Acute lymphoblastic leukemia (ALL) is a cancer involving blood and bone marrow. This type of leukemia progresses at a fast rate, creating immature white blood cells called lymphocytes.
ALL strikes about 6,000 people a year, according to the University of Maryland Medical Center. About two thirds of those affected are children. Acute lymphoblastic leukemia is the least common type of leukemia in adults.
ALL is sometimes called “acute lymphocytic leukemia.” The cause is unknown.
What Factors Determine Prognosis?
Many factors affect the prognosis and survival rate for people with ALL. Some factors include:
- whether the cancer has spread to the spinal cord or into the brain
- if the ALL is a recurrence for which the patient was previously treated
Your cancer care team will be able to assess treatment options and offer a general prognosis.
Although ALL is among the most curable cancers, the University of Maryland Medical Center reports that there are approximately 1,400 deaths each year in the United States due to ALL. The cure rate is greater in children than in adults.
General Outlook for Children
ALL is the most common form of leukemia in children. The risk of developing this form of cancer is greater in children under age 5. The prognosis for children is better than that of adults. According to St. Jude Children's Research Hospital, boys have a slightly higher rate of ALL than girls, and the cancer is more common in whites than in blacks. About 98-99 percent of children experience complete remission within six weeks of beginning treatment, and about 90 percent are leukemia-free for at least ten years, at which time they are considered to be cured.
General Outlook for Adults
Between 80 and 90 percent of adults with ALL will have remissions following treatment, according to The American Cancer Society. However, about half of those will experience a relapse, making the cure rate about 40 percent overall.
Adults over age 60 may have more complications and a worse prognosis. Although more children are diagnosed with ALL, most deaths occur in adults. Treatment may be particularly difficult for those who have other health problems or whose overall health isn’t good.
How Is ALL Treated?
Treatment must begin quickly and generally starts with intensive chemotherapy that may require hospitalization for several weeks. After that, maintenance chemotherapy may continue for a long time, often lasting three years or more. In some cases, other targeted drugs, radiation therapy, or stem cell transplants may be necessary.
While in treatment, most children and adults can carry on a fairly normal life. Older adults with advanced cases, those with other health conditions, or those at risk of serious complications may opt out of treatment and focus on symptom management.
The Psychological Toll
Successful ALL treatment means that a person has entered remission or is cured. For some patients, the end of treatment may spark fear of recurrence. For those who don’t go into remission, treatment that continues for years may increase stress and anxiety. Cancer treatment itself can cause a host of unpleasant side effects, which can lead to feelings of depression.
It is very important to continue to follow the instructions of your medical team. Feelings of anxiety, stress, and depression should be addressed with your doctor. Alternative therapies, support groups, and professional counselors may help you cope.
When ALL Comes Back
When ALL does recur, it generally happens during treatment or shortly after the end of treatment. The risk of recurrence is greatest in the first five years, and then decreases over time. In addition to chemotherapy and radiation, a recurrence may be treated with a stem cell transplant. That’s a procedure that makes use of donor stem cells to replace leukemic bone marrow. You may also be eligible to participate in clinical trials using new and experimental treatments for ALL.
What’s My Prognosis?
While your doctor can give you a general prognosis, it’s important to remember that it is subject to change. Statistics can provide helpful information, but they can’t accurately predict the outcome for any one person. That’s why it’s important that you continue to communicate with your medical team. Keep them notified of your symptoms and side effects, and ask questions so you can make informed decisions about your treatment.
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