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Survival rates for most childhood cancers have improved, with a notable improvement in acute lymphoblastic leukemia (the most common childhood cancer). Due to improved treatment, the 5-year survival rate for acute lymphoblastic leukemia has increased from less than 10% in the 1960s to about 90% during the time period 2003-2009. [16]
Because of the prolonged survival, which was typically about 10 years in past decades, but which can extend to a normal life expectancy, the prevalence (number of people living with the disease) is much higher than the incidence (new diagnoses). [2] CLL is the most common type of leukemia in the UK, accounting for 38% of all leukemia cases.
Treatment may involve some combination of chemotherapy, radiation therapy, targeted therapy, and bone marrow transplant, with supportive and palliative care provided as needed. [3] [6] Certain types of leukemia may be managed with watchful waiting. [3] The success of treatment depends on the type of leukemia and the age of the person.
Treatment usually also includes intrathecal chemotherapy since systemic chemotherapy can have limited penetration into the central nervous system and the central nervous system is a common site for relapse of acute lymphoblastic leukemia. [12] [13] Treatment can also include radiation therapy if spread to the brain has occurred. [2]
Because acute promyelocytic leukemia has the highest curability and requires a unique form of treatment, it is important to quickly establish or exclude the diagnosis of this subtype of leukemia. Fluorescent in situ hybridization performed on blood or bone marrow is often used for this purpose, as it readily identifies the chromosomal ...
Low risk MDS (which is associated with favorable genetic variants, decreased myeloblastic cells [less than 5% blasts], less severe anemia, thrombocytopenia, or neutropenia or lower International Prognostic Scoring System scores) is associated with a life expectancy of 3–10 years. Whereas high risk MDS is associated with a life expectancy of ...
These drugs have revolutionized treatment of this disease and allow most patients to have a good quality of life when compared to the former chemotherapy drugs. In Western countries, CML accounts for 15–25% of all adult leukemias and 14% of leukemias overall (including the pediatric population, where CML is less common).
Some studies have found no difference in life expectancy or quality of life between asymptomatic patients who receive treatment and those who are closely monitored without treatment. Other doctors believe that potentially curative radiation therapy is underused, and that this may lead to excessive treatments and costs in the long term.