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Leukemia (cont.)

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What are complications of leukemia?

Many of the challenges of leukemia relate to the depletion of normal blood cells as well as the side effects of treatments as described in the previous section, such as frequent infections, bleeding, and GVHD in recipients of stem cell transplants. Weight loss and anemia are further complications of leukemia and its treatment. Complications of any leukemia also include a relapse or a progression of the disease after a remission has been achieved with treatment.

Other complications of leukemia relate to the specific type of leukemia. For example, in 3% to 5% of cases of CLL, the cells change characteristics and transform into an aggressive lymphoma. This is known as a Richter transformation. Autoimmune hemolytic anemic, in the body attacks and destroys red blood cells, is another potential complication of CLL. People with CLL are also more likely to develop second cancers and other blood disorders and blood cancers.

Tumor lysis syndrome is a condition caused by the rapid death of cancer cells during acute treatment. It can occur in almost any type of cancer, and it is seen with some cases of leukemia, particularly when large numbers of leukemia cells are present such as with AML or ALL. The rapid destruction of the leukemia cells leads to the release of large amounts of phosphate, which further causes metabolic abnormalities and can lead to kidney failure.

Children who receive therapy for ALL may experience late adverse effects including central nervous system (CNS) impairment, slowing of growth, infertility, cataracts, and an increased risk for other cancers. The incidence of these late effects varies depending upon the age at treatment and the type and strength of therapies.

What is the prognosis of leukemia?

The prognosis of leukemia depends upon the type of leukemia that is present and the age and health status of the patient. Mortality (death) rates for leukemia are higher in the elderly than in younger adults and children. In many cases, leukemia can be managed or cured with treatments available today. In particular, childhood ALL has a very high 5-year survival rate.

Modern treatments have led to a greater than fourfold increase since 1960 in five-year survival rates for leukemia. Five-year survival rates for different types of leukemia are approximately:

CML: 66%

CLL: 83%

AML: 27% overall, 64% for children and teens younger than 15

ALL: 71% overall, over 90% for children

Medically Reviewed by a Doctor on 6/19/2017


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