It very uch depends on what phase the disease is in.
quote:Survival after development of an accelerated phase is usually less than 1 year and after blastic transformation is only a few months.
Transition from the chronic phase to the accelerated phase and later the blastic phase may occur gradually over a period of 1 year or more, or it may appear abruptly (blast crisis). The annual rate of progression from chronic phase to blast crisis is 5% to 10% in the first 2 years and 20% in subsequent years.  
Book, I don't know if my friend had the same type of leukemia, but he had it at 19 or 20 and beat it. He is now 30, been cancer free for eight years, and has two small children. He didn't think he was going to live, and he thought, if he did live, he wouldn't be able to father children (he banked prior to starting treatment, just in case), but it turned out to be the best of all possible outcomes. I'll hope the same outcome for your friend.
Posts: 5948 | Registered: Jun 2001
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quote:Recently the prognosis of patients with CML has improved from an expected median survival of 3 years and a 5-year survival rate of less than 20% to a median survival of 5 or more years and a 5-year survival rate of 50-60%. The improvement is due to earlier diagnosis, improved therapy with interferon and BMT, and better supportive care. A German study of 139 low-risk patients with CML, according to the Sokal index, shows that the median survival with busulfan is 6 years (50 patients), with hydroxyurea is 6.5 years (55 patients), and with interferon alfa is approximately 9.5years (34 patients), indicating improvement in survival with new therapy. The new and active tyrosine kinase inhibitor, imatinib [Gleevec], is associated with a higher response rate and better tolerance of adverse effects. It may replace interferon as first-line therapy. Long-term remissions remain to be seen, and imatinib will be reevaluated in the near future to determine its role in the treatment of CML.
ie Success in treatment of CML has risen so rapidly that the numbers -- generated by cases which were originally diagnosed 10 or more years ago -- are misleadingly negative because those numbers are from test cases establishing optimum treatment for this new generation of patients. Test cases would tend to have lower survival times due to lack of complete knowlege about the best dosages/etc. The survival rate and times of those diagnosed recently should be much higher. Perhaps sufficiently higher that even the pace of discovery of not-yet-invented successful treatments with even higher survival rates-and-times will outrun the death rate-and-time of currently standard treatments.
quote:Some patients with molecular remissions from interferon alfa may be cured, but this can only be established over time.
ie It will take about 60years of comparison with the rest of the population to be able to say "CML survivors will live as long as folks who never had CML." or not.
CML can be cured with a bone marrow transplant. The procedure is risky because it requires that your own bone marrow be killed by either radiation or chemotherapy before the transplant. It is not an option for some patients because they are either to sick to tolerate the process or they can not find a compatible donor.
Long term survival rates for CML patients following a bone marrow transplant vary between 75% and 50% depending on the donor type. Chances of survival are best if the donor is a sybling whose immune system type matches that of the patient.
I have a good friend who had CML about 15 years ago. He was one of the earlier patients treated with a bone marrow transplant and is fully cured.
In 2001 they approved a drug, Gleevec, for treatment of CML. The results are promising but since it has only available for a short period of time it is unclear whether the results will be lasting.
The current standard of care is to treat with Gleevec while closely monitoring the bodies cellular and molecular response to the drug. If the patient does not respond, or stops responding then they would probably do a bone marrow transplant assuming that the patient is elligible.
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In other words, CML patients shouldn't give up on planning&working for a future. Otherwise, thirty years from now, there is a good chance that they'll be regretting giving up on their dreams for a death that didn't happen.
Posts: 8501 | Registered: Jul 2001
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