Prognosis and duration

Acute Myeloid Leukaemia (AML)

People with AML are likely to be very ill on diagnosis, and need to undergo immediate treatment. Many of them will relapse and require more treatment quite quickly, if first relapse occurs within 3 years of initial treatment, median survival is around 6 months. If first relapse occurs 3 years or more after initial treatment median survival is 18 months.

Long term survival after treatment depends on subtype of leukaemia and age. 40% of people of all ages will survive for 3 years after treatment and many of these will be long term survivors – they may be ‘cured’. Long term survival is improved for people under 60, the younger they are the better chance they have of long term survival. 5 year survival rates for people under 60 are about 55%.

Most deaths from leukaemia occur within the first few years after diagnosis. Those who do become long term survivors are likely to have undergone arduous treatment in addition to being very ill with their leukaemia in the first place. It is recommended that if needs are identified that awards are made for two years. Those who are going to recover from their AML are likely to have substantially done so at 2 years. Those still undergoing treatment or who have needs at 2 years are likely to have ongoing needs; indefinite awards at 2 year review are recommended for these people.

Acute Lymphoblastic Leukaemia (ALL)

People with ALL are likely to be very ill on diagnosis; about 80% will go into remission with their first course of chemotherapy. Despite aggressive consolidation therapy the majority of them (60%) will relapse again quite quickly. Further treatment may be able to control the disease for a little longer but will not cure it. Without bone marrow transplant treatment first relapse leads to death on average within a year.

Long term survival after treatment depends on subtype of leukaemia and age. 2 year survival with ALL is 35-40% for people under 55 years of age; for older people long term survival rates are lower.

Most deaths from leukaemia occur within the first few years after diagnosis. Those who do become long term survivors are likely to have undergone arduous treatment in addition to being very ill with their leukaemia in the first place. It is recommended that if needs are identified that awards are made for two years. Those who are going to recover from their ALL are likely to have substantially done so at 2 years. Those still undergoing treatment or who have needs at 2 years are likely to have ongoing needs; indefinite awards at 2 year review are recommended for these people.

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• Bone marrow transplant

Chronic Myeloid Leukaemia (CML)

Routine review of any awards made is recommended.

Blast phase

Those with blast phase will have needs, they are likely to be very ill with many of the symptoms of acute leukaemia, many of them will be terminally ill. Reduced mobility is expected because of anaemia and breathlessness; help may be required with all aspects of daily living. Only about 30% will respond to treatment and median survival for the non-responders is 2-4 months. Those who undergo successful bone marrow or stem cell transplant are likely to become the long term survivors it is recommended awards are given with review at 2 years to those undergoing bone marrow or stem cell transplant. Indefinite awards are recommended for all those who are unable to have this treatment.

Chronic Lymphocytic Leukaemia (CLL)

Time limited awards coinciding with expected recovery from treatment are recommended for those undergoing chemotherapy treatments for newly diagnosed or first relapse of CLL, this includes those having bone marrow transplant treatment. At review if treatment is ongoing, needs are present or medical evidence describes the patient as having advanced (stage C) disease, indefinite awards are recommended.

All information must be taken into account when considering the duration of disabling effects and the duration of disabling effects must be based on the particular circumstances of the individual claimant.

Amended February 2009