Chronic myeloid leukemia prognosis
The median survival time of patients with CML after their diagnosis is around 3 to 5 years. However, with the introduction of new drugs and the improvement of the treatment protocols, the median survival time has been increasing through the years. Back in the 1990s, only 31% of patients survived longer than 5 years, and in 2015 this survival rate has reached 69%.
Better prognosis always results from a combination of early diagnosis, early start of therapy, and new targeted drugs that make treatment easier. Bone marrow transplantation is the only way to cure the disease, but the procedure is dangerous and has a very high rate of mortality by itself. Thus, it is not justified in most cases.
The risks of patients with chronic myeloid leukemia can be classified as a good risk with a survival of 5 or more years, an intermediate risk with a survival of 3 or 4 years, and poor-risk, with a survival of 2 years. Each one of these categories also has a percentage of response to treatment, which becomes reduced as the risk becomes higher. One of the ways to calculate the risk is through the Sokal score, which takes into consideration spleen size, age, platelet count, and the percentage of blast cells in the blood.
Among the most important characteristics that dictate a poor prognosis, we have:
- Patients with an older age
- Symptomatic patients unresponsive to medical treatment
- African American patients
- Splenomegaly and hepatomegaly
- CML with a negative Philadelphia chromosome
- Thrombocytopenia, thrombocytosis, anemia, basophilia