Median survival is 4-6 years (can range from less than 1 year to more than 10 years)
however occasionally patients die within a few months
3% of patients live more than 15 years without radical therapy
once the accelerated phase is reached survival is usually less than 1 year and in the blast phase, few patients survive more than a few months (1).
It is important to identify the prognostic factors at diagnosis. The following can be used to provide useful prognostic information in a patient with CML:
accurate identification of the disease stage (or phase) is considered to be the essential factor
clinical and laboratory features - used to calculate prognostic scores (Sokal score or Hasford score)
these scores identifies patients with low, intermediate, and high risk of short term survival
cytogenetic changes e.g. - deletions of the derivative chromosome 9
Imatinib can be used to partly overcome the negative prognostic effects of this
but the size and location of the deletion appears to be important
degree and timing of haematological, cytogenetic, and molecular responses (2)
Approximately 60% of young adults with successful allogeneic bone marrow transplantation are cured.
Studies have revealed that the following features are predictive of a shorter chronic phase:
increased splenomegaly.
older age
chronic myeloid leukaemia mortality is strongly related to age, with the highest mortality rates being in older people. In the UK in 2014-2016, on average each year two-thirds (66%) of deaths were in people aged 75 and over
male gender
elevated serum lactate dehydrogenase.
cytogenetic abnormalities in addition to the Ph1.
a higher proportion of marrow or peripheral blood blasts.
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