Acute myeloid leukemia
is a curable disease; the chance of cure for a specific patient depends on a number of prognostic factors.
The single most important prognostic factor in AML is cytogenetics, or the chromosomal structure of the leukemic cell. About half of AML patients have "normal" cytogenetics; they fall into an intermediate risk group. A number of other cytogenetic abnormalities are known to associate with a poor prognosis and a high risk of relapse after treatment.
AML which arises from a pre-existing myelodysplastic syndrome
or myeloproliferative disease
(so-called secondary AML) has a worse prognosis, as does treatment-related AML arising after chemotherapy
for another previous malignancy. Both of these entities are associated with a high rate of unfavorable cytogenetic abnormalities.
Other prognostic markers
In some studies, age >60 years and elevated lactate dehydrogenase level were also associated with poorer outcomes.
As with most forms of cancer, performance status (i.e. the general physical condition and activity level of the patient) plays a major role in prognosis as well.
FLT3 internal tandem duplications (ITDs) have been shown to confer a poorer prognosis in AML.
Treating these patients with more aggressive therapy, such as stem-cell transplantation
in first remission, has not been shown to enhance long-term survival, so this prognostic feature is of uncertain clinical significance at this point.
Overall expectation of cure:
The overall cure rate for all patients with AML (including the elderly and those unable to tolerate aggressive therapy) is likely lower. Cure rates for promyelocytic leukemia
can be as high as 98%.
ESTIMATION OF TIME NEEDED FOR CURE IS HOWEVER NOT POSSIBLE,AND DEPENDS ON TREATMENT METHOD.
IN SIMPLE WORDS YOUR REPORT OF NORMAL CYTOGENESIS AND NEGATIVE FLT3,YOUNG AGE SUGGESTS A VERY GOOD OUTCOME,HB% WILL IMPROVE AS TREATMENT GOES ON.,DONT WORRY.!