The prognosis depends a lot on the patient’s age and the type of cancer.
Each year in France, nearly 45,000 men and women are diagnosed with blood cancers. This family of cancers includes leukemias (chronic or acute), lymphomas, myelomas, and even myeloproliferative neoplasias (rarer). These cancers are frightening because most of the time they progress silently, without specific symptoms, and are therefore detected late, which inevitably reduces life expectancy.
The prognoses of blood cancers could be determined using molecular research and markers. “The prognosis for blood cancers remains very variable. He frankly depends on several parameters, such as the type of disease, the progress of the cancer, the results of blood tests or even the age of the patient at diagnosis. For example, we can have leukemias with a good prognosis as well as leukemias with a poor prognosis, myelomas with a good prognosis as well as poor prognosis. For Hodgkin’s lymphoma, in 90% of cases, the disease is curable very well in a young patient under 20 years old.“, answers Dr Nathalie Chéron, head of the hematology department at the Bligny Hospital Center.
The prognosis also depends on the patient’s karyotype and the presence of cytogenetic abnormalities (alteration of genetic material such as abnormalities in the chromosomes, editor’s note). “For leukemia or myeloma, schematically, we can say that the fewer cytogenetic abnormalities the person has, the better the prognosis. On the other hand, the more cytogenetic abnormalities or complex chromosome abnormalities the person has, the more serious the situation will be and the more guarded the prognosis will be.“, indicates Dr. Chéron.
The prognosis also depends on the context of appearance and the contributing factors. For example, leukemia induced by exposure to pesticides, insecticides or herbicides (the case of certain farmers for example who are more at risk of developing leukemia) generally has a poorer prognosis. Same thing for leukemia secondary to breast cancer. “Chemotherapy treatment can in the long term lead to secondary leukemia which generally has a poor prognosis.explains our interlocutor. It is therefore very complicated to give precise predictions, as they depend on several factors..”
Survival estimates based on cancer type were given by Public health France in a study on the survival of people with cancer in mainland France over the most recent period (2010-2015). Lower survival is observed as the age at diagnosis increases, with a more marked difference for certain blood cancers.
→ The acute myeloid leukemia (7% of new annual cases of blood cancers), presents the most unfavorable prognosis, with an average 5-year survival of 27%. The disparities are significant depending on age: 69% for the youngest people (30 years old) compared to 6% among the oldest (80 years old).
→ The chronic myelogenous leukemia has a generally favorable prognosis with survival estimated at 96% at 1 year and 85% at 5 years, regardless of age at diagnosis.
→ The Hodgkin’s lymphoma is a cancer with a good prognosis with a 5-year survival rate of 84% for all forms combined.
→ The follicular lymphoma is well taken care of initially with a survival rate of 86% at 5 years, but the relapse rate is almost inevitable
→ The diffuse large B-cell lymphoma has a standardized net survival of 76% at 1 year and 61% at 5 years regardless of age at diagnosis.
→ The multiple myeloma has a 5-year survival of between 42% and 63% (best in the youngest)
Overall, over the past 10 years, we have observed a clear improvement in survival for the majority of blood cancers., thanks to both therapeutic advances as well as actions implemented to diagnose cancers at an earlier stage and to improve their management. “If all these diseases were detected early enough, they could be treated more easily and the prognosis would be better“, concludes the hematologist.