Acute Myeloid Leukemia Treatment and Survival Rate

April 19, 2024 
This page was reviewed under our medical and editorial policy by Guido Marcucci, M.D., Chair, Department of Hematologic Malignancies Translational Science, City of Hope Duarte

Treatment plans for acute myeloid leukemia (AML) are tailored to each patient’s individual needs. Doctors consider factors such as cancer subtype and whether the leukemia is newly diagnosed, in remission or a recurrence. A patient’s age and overall health are other key considerations.

Gathering as much information about the cancer as possible during the acute myeloid leukemia diagnosis process helps inform treatment decisions and may lead to improved outcomes and survival rates.

AML Treatment Options

AML treatment typically includes two main phases: induction and consolidation.

Induction phase: During the induction period, chemotherapy drugs are deployed in the hospital setting with the goal of remission. With AML, remission means having normal blood cell counts with less than 5% of immature white blood cells or blasts in the bone marrow and no signs or symptoms of cancer. Patients under 60 often receive the most intensive chemotherapy, but some older people are strong enough to receive similar treatment. Induction therapy is often built on what is known as a 7+3 regimen — seven days of continuous treatment with the chemotherapy drug cytarabine (Ara-C, Cytosar-U®), with brief infusions of an anthracycline such as daunorubicin (Cerubidine®) during the first three days. Sometimes, a third drug is added.

Most patients with AML achieve clinical remission after a single round of induction chemotherapy. However, patients will be monitored, and some may need additional induction treatments, while others will move onto the consolidation phase of treatment.

Consolidation phase: Also called the post-remission phase of AML treatment, this period involves courses of chemotherapy to get rid of any errant leukemia cells. It is most successful if given right after a patient achieves remission. For patients under 60, the main options for this therapy are several cycles of high-dose cytarabine (Ara-C) or a stem cell transplant, either using the patient’s own stem cells or those from a donor.

Doctors and their patients decide on an appropriate course of treatment based on a patient’s risk for the cancer to return. Consolidation therapy typically lasts at least several months, but protocols vary based on age and overall health status. For example, older patients or those in poor health may not tolerate intensive consolidation treatments.

People deemed at higher risk for relapse may also undergo maintenance therapy, which involves administration of lower doses of medication over a longer time.

Acute Promyelocytic Leukemia Treatment

Acute promyelocytic leukemia (APL), a subtype of AML, requires a different approach to treatment. With APL, treatment is started quickly after diagnosis with two drugs: all-trans retinoic acid and arsenic trioxide. These drugs help stop the leukemia cells from growing. Other chemotherapy may be needed as well, depending on the patient’s personal risk.

Acute Myeloid Leukemia Survival Rate

AML accounts for roughly one-third of adult leukemias. While leukemia is a common blood cancer, acute myeloid leukemia accounts for only about 1% of all cancers. Roughly 20,800 cases of AML are expected to be diagnosed in the United States in 2024, and about 11,220 people are projected to die from this cancer in 2024.

The five-year relative survival rate is the percentage of patients who are alive at least five years after diagnosis, compared to people without that cancer type. According to the American Society of Clinical Oncology, for people aged 20 and older with AML, the five-year relative survival rate is 28%. For patients under age 20, the rate is 69%.

According to the National Cancer Institute, over the past 20 years, more patients are surviving longer each year with treatment. AML survival rates vary by age, general health status and how well an individual’s treatment plan works. Attacking the cancer early and aggressively is known to boost survival odds. Always talk to the health care team about each patient’s specific prognosis.

References
References
  • National Cancer Institute (2024, January 19). Acute Myeloid Leukemia Treatment (PDQ®)–Health Professional Version. 
    https://www.cancer.gov/types/leukemia/hp/adult-aml-treatment-pdq#_46

  • American Cancer Society (2023, July 21). Typical Treatment of Acute Myeloid Leukemia (Except APL). 
    https://www.cancer.org/cancer/types/acute-myeloid-leukemia/treating/typical-treatment-of-aml.html

  • American Cancer Society (2023, July 21). Targeted Therapy Drugs for Acute Myeloid Leukemia (AML). 
    https://www.cancer.org/cancer/types/acute-myeloid-leukemia/treating/targeted-therapy.html

  • National Cancer Institute (2021, November 11). Drug combination helps children with acute promyelocytic leukemia avoid conventional chemotherapy. 
    https://www.cancer.gov/news-events/press-releases/2021/treatment-helps-children-apl-avoid-chemotherapy

  • American Cancer Society (2018, August 21). Treatment of Acute Promyelocytic Leukemia (APL). 
    https://www.cancer.org/cancer/types/acute-myeloid-leukemia/treating/m3-leukemia.html

  • American Society of Clinical Oncology (2023, February). Leukemia - Acute Myeloid - AML: Statistics. 
    https://www.cancer.net/cancer-types/leukemia-acute-myeloid-aml/statistics

  • StatPearls [Internet]. Vakiti A, Mewawalla P (2023, August 8). Acute Myeloid Leukemia. 
    https://www.ncbi.nlm.nih.gov/books/NBK507875/

  • American Cancer Society (2024, January 17). Key Statistics for Acute Myeloid Leukemia (AML). 
    https://www.cancer.org/cancer/types/acute-myeloid-leukemia/about/key-statistics.html

  • National Cancer Institute. Acute Myeloid Leukemia (AML): Recent Trends in SEER Relative Survival Rates, 2000-2020. 
    https://seer.cancer.gov/statistics-network/explorer/application.html?site=96&data_type=4&graph_type=2&compareBy=age_range&chk_age_range_1=1&relative_survival_interval=5&sex=1&race=1&hdn_stage=101&advopt_precision=1&advopt_show_ci=on&hdn_view=0&advopt_show_apc=on&advopt_display=2#resultsRegion0