Can I Survive CML? What Is My Prognosis?
It may sound harsh to ask the question, “Can I survive this?,” but it’s a question on most people’s minds when they are facing a diagnosis of chronic myeloid leukemia (CML). And hearing the answer can be just as hard as asking the question.
How you respond to treatment depends on these things:
How quickly the leukemia cells are likely to grow
Your general health
A prognosis is a statement about the prospect of surviving and recovering from a disease. Before discussing your prognosis with you, your doctor will consider all things that could affect the leukemia and your treatment. Your doctor will then predict what seems likely to happen. To do that, the doctor looks at what researchers have found out about people with leukemia. This data may cover many years and hundreds or even thousands of people with leukemia. When possible, the doctor uses statistics based on groups of people whose situations are most like yours to make a prediction.
If your leukemia is likely to respond well to treatment, your doctor may say you have a favorable prognosis. If the leukemia is likely to be hard to control, your prognosis may be unfavorable. It is important to keep in mind, though, that a prognosis states what is probable. It is not a prediction of what will happen. No doctor can be absolutely certain about the outcome.
As a person with leukemia, you face many unknowns. So does your family. Some people find it easier to cope when they know their prognosis and the statistics for how well a treatment might work. Other people find statistical information confusing and frightening. Or they may think it is too general to be of use. The doctor who is most familiar with your situation is in the best position to discuss your prognosis and to explain what the statistics may mean for you. At the same time, it is important to understand that even your doctor cannot tell exactly what to expect. In fact, a person’s prognosis may change if the disease progresses or if treatment is successful. The decision to ask about your prognosis is a personal one. It is up to you to decide how much you want to know.
How your CML phase affects your prognosis
When trying to determine your best course of treatment and your prognosis, your doctor will take into account your phase of leukemia, as well as other factors.
Factors that worsen your prognosis are called adverse prognostic factors. Those that improve your prognosis are called favorable prognostic factors. Your doctor looks at your prognostic factors as well your phase to help find the best treatment plan for you.
Here's a list of adverse prognostic factors:
You are in an accelerated phase or blast phase.
You have an enlarged spleen.
You have areas of bone damage due to the leukemia.
You have increased numbers of basophils and eosinophils (types of granulocytes) in circulating blood samples.
You have very high or very low platelet counts.
You are age 60 or older.
Tests show you have multiple chromosomal changes in your CML cells.
What does the 5-year survival rate mean?
Survival rates indicate the percentage of people with a certain type of leukemia who survive the disease for a certain period of time after their diagnosis. Often, statistics refer to the 5-year survival rate, which is the percentage of people who live 5 years after diagnosis. People with CML who are included in the 5-year survival pool include:
Those who are free of disease
Those who have few or no signs or symptoms of leukemia
Those who are having treatment for leukemia
Many people with CML live much longer than 5 years after diagnosis. Because the statistics we have for 5-year rates now are based on people diagnosed and initially treated more than 5 years ago, it’s possible that the outlook could be even better today. That’s because of improvements in treatment.
Survival rates are based on large groups of people. They cannot be used to predict what will happen to a certain person. No 2 people are exactly alike. Treatment and responses to treatment vary greatly.
What are the treatment statistics for CML?
Very effective treatments called targeted drugs for CML first became available about 10 years ago. Survival rates for CML have improved dramatically since that time, but these drugs have not been in use long enough to provide accurate long-term survival rates yet. According to some studies, at least 9 out of 10 people with CML are still alive 5 years after their diagnosis, and many of these people have no symptoms from their disease.