Yes; many types of leukaemia (blood cancer) can be cured, and the others can often be controlled for many years, but the chance of cure depends on the type of leukaemia, age and the genetic changes in the cancer cells [1, 4]. Of every 10 children with acute lymphoblastic leukaemia (the commonest cancer in children), 9 are alive 5 years later [5, 8]; in a large study, after treatment without chemotherapy, almost all patients with acute promyelocytic leukaemia were still free of the disease 2 years later [3], and most people with chronic myeloid leukaemia have a near-normal life expectancy with one daily tablet [10]. Without treatment, acute leukaemia gets worse quickly; so if you have been diagnosed, start treatment promptly and complete it [4].
Key points
- Leukaemia is not one disease; it has several main types, and the chance of cure differs from one type to another [1, 4, 10, 11].
- Children: of every 10 children with the commonest type (acute lymphoblastic leukaemia), 9 are alive 5 years later [5, 6].
- Acute promyelocytic leukaemia: in a large study of patients whose white cell count was not very high at the start, tretinoin tablets and an arsenic injection, without chemotherapy, brought every patient into remission, and 2 years later almost all were still free of the disease [3].
- Chronic leukaemias usually do not go away completely, but they can be controlled for many years; most people with chronic myeloid leukaemia have a near-normal life expectancy with a daily tablet [10, 11].
- In adults, acute leukaemias are harder to cure, especially in older people; but some patients, particularly younger ones, are cured [1, 2, 4].
Is leukaemia curable? It depends on the type
Leukaemia (blood cancer) means that the cells that make blood in the bone marrow multiply out of control. It has four main types: two "acute" types that get worse quickly without treatment, and two "chronic" types that often progress slowly [4, 11]. To understand how leukaemia differs from lymphoma and myeloma, read: Leukaemia, lymphoma and myeloma: what is the difference?
Doctors have two aims of treatment: cure, which means getting rid of the disease completely and is the main aim in acute leukaemias [1]; and long-term control, which means keeping the disease in check for years and is the aim in most chronic leukaemias [10, 11].
| Type of leukaemia | Aim of treatment | Results of treatment today |
|---|---|---|
| Acute lymphoblastic leukaemia in children | Cure | Of every 10 children, 9 are alive 5 years later [5, 6] |
| Acute myeloid leukaemia in children | Cure | In a large European group, 3 of every 4 children were alive 5 years later [7] |
| Acute promyelocytic leukaemia | Cure | In a large study of patients whose white cell count was not very high at the start, treatment without chemotherapy brought every patient into remission, and 2 years later almost all were free of the disease [3] |
| Acute lymphoblastic leukaemia in adults | Cure | Of every 10 people, 6 to 8 go into remission with the first treatment; in a large study, about 4 of every 10 were alive 5 years later [4] |
| Acute myeloid leukaemia in adults | Cure | Of every 10 people, 6 to 7 go into remission with the first treatment, and more than 1 in 4 may be cured; results are much better in young people than in older people [1, 2] |
| Chronic myeloid leukaemia | Long-term control with a daily tablet | More than 9 of every 10 people are alive 10 years later; most people have a near-normal life expectancy [10] |
| Chronic lymphocytic leukaemia | Long-term control; often just monitoring at first | It usually does not go away completely, but with newer medicines more than half of patients live for more than 10 years [11] |
These figures are averages from large numbers of patients, sometimes from years ago, and cannot predict exactly what will happen to one person; results of treatment have improved over time [2, 5].
Is acute leukaemia curable?
Yes; the aim of treatment for acute leukaemia is cure. Without treatment, acute leukaemia gets worse quickly, so treatment needs to start soon [4]. Treatment has two phases: first, intensive treatment to reach "remission" (meaning no cancer cells can be seen in the usual tests), then further treatment to stop the disease from coming back [1].
- Acute myeloid leukaemia: of every 10 adults, 6 to 7 go into remission with the first treatment, and more than 1 in 4 may be cured [1]. Age matters a great deal: in the United States between 2010 and 2017, about 6 of every 10 patients aged 15 to 39 were alive 5 years later, but in people aged 70 or over only about 1 in 20 [2]. Since then, new medicines for older people have become available [2]; read: Treating acute myeloid leukaemia in older adults.
- Acute promyelocytic leukaemia: a special type of acute myeloid leukaemia with a risk of serious bleeding at the start [1]. In a large study of patients whose white cell count was not very high at the start, every patient treated with tretinoin tablets and an arsenic injection, without chemotherapy, went into remission [3]. Read more: Treating acute promyelocytic leukaemia.
- Acute lymphoblastic leukaemia in adults: of every 10 people, 6 to 8 go into remission with the first treatment [4]. In the type that has the "Philadelphia chromosome" (more than 3 of every 10 adults with this leukaemia), adding targeted tablets to chemotherapy now makes long-term survival possible [4].
Read the details of each type on the leukaemia page.
Can leukaemia in children be cured?
Yes; most children with leukaemia are cured. Acute lymphoblastic leukaemia is the commonest cancer in children [8]. In a large treatment group in the United States, 9 of every 10 children and teenagers with this leukaemia were alive 5 years later [5]. In childhood acute myeloid leukaemia, 3 of every 4 children in a large European group were alive 5 years later [7].
Treatment of acute lymphoblastic leukaemia in children takes more than 2 years. In the last phase, which is the longest, the child takes tablets every day and has other medicines at set intervals [6]. Give these tablets every day until the end; read: Is childhood cancer curable?
What are the symptoms of leukaemia in children?
The symptoms of leukaemia in children can include [8]:
- fever, or infections that keep coming back or do not go away
- pale skin, weakness and tiredness
- bruising or bleeding easily, and tiny dark-red spots under the skin
- bone or joint pain
- painless lumps in the neck, armpit or groin
- pain or a feeling of fullness below the ribs, loss of appetite and weight loss
- shortness of breath
These symptoms can have other causes too; the only way to know is to have your child seen by a doctor [8]. Read more: Warning signs of cancer in children and Symptoms of leukaemia.
How long can you live with leukaemia? Leukaemia survival rates
Life expectancy with leukaemia depends on the type of leukaemia. The figures are averages from large numbers of patients and cannot predict exactly what will happen to one person.
- Chronic myeloid leukaemia: with targeted tablets such as imatinib, more than 9 of every 10 people are alive 10 years later, and most people are expected to have a near-normal life expectancy [10]. In the first large study of imatinib, more than 8 of every 10 people were alive 10 years later [9]. Read more: Treating CML: a near-normal life with one tablet.
- Chronic lymphocytic leukaemia: it usually does not go away completely, but it often progresses slowly [11]. In older studies, half of patients lived for 8 to 12 years or more; with the newer targeted medicines, more than half of patients are alive after more than 10 years [11]. Read more: The best treatment for CLL.
- Acute leukaemias: the aim of treatment is cure. In acute myeloid leukaemia, more than 1 in 4 adults live for 3 years or more and may be cured [1]. If the disease comes back after treatment, there are still treatment options: a stem cell transplant cures more than 3 of every 10 patients whose acute myeloid leukaemia has come back [1].
How long does leukaemia treatment take?
| Type of leukaemia | Length of treatment |
|---|---|
| Acute lymphoblastic leukaemia in children | More than 2 years; in a large study, the last phase of treatment alone lasted about 2 years and 4 months in girls and nearly 3 years in boys [6] |
| Acute lymphoblastic leukaemia in adults | On average 1.5 to 3 years [4] |
| Acute myeloid leukaemia | One course of intensive treatment to reach remission, then several courses of further treatment; in some patients a stem cell transplant [1] |
| Acute promyelocytic leukaemia | If the white cell count is not very high at the start: tretinoin tablets and arsenic injections in two phases, without chemotherapy and without long maintenance treatment [3] |
| Chronic myeloid leukaemia | A daily tablet for years; in some people with a very deep response, after at least 3 to 5 years, stopping the medicine under a doctor's supervision may be possible [10] |
| Chronic lymphocytic leukaemia | If there are no symptoms, monitoring only [11]; if treatment is needed, either a daily tablet taken continuously, such as ibrutinib [11], or a fixed 1-year course, such as venetoclax with an antibody [12] |
The exact plan for each patient is set by the care team according to the type of leukaemia, genetic tests and the response to treatment.
What affects the chance of cure?
- The type of leukaemia and the genetic changes in the cancer cells: chromosome and gene tests give the most important information about the chance of cure [1].
- The response to the first treatment: how quickly and how far the number of leukaemia cells falls predicts the outcome [8]. With very sensitive tests, doctors also measure tiny amounts of leukaemia left behind; in a study of children, a larger amount remaining after 6 weeks of treatment was linked to a worse outcome [6].
- Age and general health: in acute myeloid leukaemia, younger people are more likely to go into remission [1, 2].
- Stem cell transplant: in acute myeloid leukaemia with a high risk of coming back, a transplant from a donor is an option for cure [1]. Read more: Blood stem cell transplant.
What you can do: continue treatment as planned until the end, do not miss tablets, and go to your appointments and tests (why complete, on-time treatment matters).
When should I contact my doctor?
If you or your child are being treated for leukaemia, contact your care team straight away or go to the emergency department if you have:
- a temperature of 38°C or higher, or shivering; during treatment the white blood cells are low and an infection can be dangerous (low blood counts and infection)
- bleeding that does not stop, a lot of bruising or new red spots on the skin
- shortness of breath, chest pain, a severe headache or confusion
- vomiting that stops you taking your medicines, or several days of missed medicines
Before a diagnosis, too, have a long-lasting fever, paleness, unexplained bruising or bone pain checked by a doctor soon [8]. In an emergency, call your local emergency number.
Frequently asked questions
Is leukaemia fatal?
Is acute or chronic leukaemia more dangerous?
Acute leukaemia progresses quickly and needs urgent, intensive treatment, but the aim of its treatment is cure [1, 4]. Chronic leukaemia is slower and can often be controlled for years, but it usually does not go away completely [11]. So which is more dangerous depends on the exact type, age and genetic tests.
My treatment has finished and I feel well; does that mean the leukaemia will not come back?
The longer you go without the disease coming back, the better the chance that you are cured; for example, in acute myeloid leukaemia, patients who live for 3 years or more may be cured [1]. Even so, keep going to your follow-up appointments, because late effects of treatment can appear months or years later [8].
Can the tablets for chronic myeloid leukaemia be stopped?
Sometimes yes, but only under a doctor's supervision. The best candidates for trying to stop are people who have taken the tablets for more than 3 to 5 years and have a very deep response [10]. About half of the people who stop find that the disease comes back; but almost all respond again when they restart the same tablet [10]. Do not stop the tablets on your own.
I have chronic lymphocytic leukaemia, but my doctor says I do not need treatment yet; why?
For people without symptoms, regular monitoring is the accepted approach [11]. In studies that started treatment with an older medicine in these patients early or later, survival at 10 years was no different, and no study has yet shown that starting the newer medicines early is better [11]. Treatment starts when symptoms or important changes in the blood tests appear.
Is a bone marrow transplant always needed?
No. Many patients are cured or controlled without a transplant; for example, acute promyelocytic leukaemia is treated with tablets and an injection [3], and in chronic myeloid leukaemia tablets are the main treatment [10]. A transplant is used mainly for acute leukaemia with a high risk of coming back, or that has come back [1]. Read more: Blood stem cell transplant.
Is lymphoma curable too?
Lymphoma is a different cancer that starts in the lymph nodes, and its chance of cure also depends on its type; read: Is lymphoma curable?
Key survival and prognostic figures (for doctors)
For physicians
Adult AML. Based on SEER data from 2014 to 2020, 31.9% of patients were alive 5 years after diagnosis; 60% to 70% achieve CR after appropriate induction, and more than 25% (about 45% of those who achieve CR) survive 3 years or more and may be cured. Cytogenetic and molecular findings give the strongest prognostic information; mutated NPM1 without FLT3-ITD confers a better prognosis, and a WBC above 100,000/mm3 is adverse. The adverse-risk group is highly unlikely to be cured with consolidation chemotherapy, and allogeneic transplant in first CR is a reasonable option; allogeneic transplant cures more than 30% of patients who relapse after chemotherapy [1]. In SEER (29,107 patients with de novo AML, 1980 to 2017), overall 5-year survival in the four periods was 9%, 15%, 22% and 28%; at ages 15 to 39 it reached 63%, but at 70 years or older it remained 5% in 2010 to 2017, and 4-week mortality in adults and older patients was 20% to 45% [2].
APL (APL0406). In low-to-intermediate-risk disease (WBC ≤10×109/L), CR was 100% (77 of 77) with ATRA plus arsenic trioxide and 95% with ATRA plus chemotherapy; 2-year EFS was 97% vs 86% (P<0.001 for noninferiority and P=0.02 for superiority), overall survival was better (P=0.02), with less haematological toxicity and fewer infections but more hepatic toxicity [3].
Adult ALL. CR after induction is 60% to 80%, and more than 90% in Ph-positive disease when a TKI is added; in the largest study (1,913 adults), 5-year overall survival was 39%. Ph-positive disease accounts for more than 30% of adult cases. Treatment lasts 1.5 to 3 years on average. Patients who relapse after remission usually die within 1 year, even if a second CR is achieved; in these patients, bone marrow transplant may be considered if a suitable donor is available and the patient is younger than 55 [4].
Childhood ALL. In the COG (21,626 patients aged 0 to 22), 5-year survival rose from 83.7% (1990 to 1994) to 90.4% (2000 to 2005) [5]. In St. Jude Total XV (498 patients, no prophylactic cranial irradiation), 5-year EFS and OS were 85.6% and 93.5%; MRD ≥1% after 6 weeks of induction was associated with worse EFS, and continuation therapy lasted 120 weeks in girls and 146 weeks in boys [6].
Childhood AML. In AML-BFM (1,940 patients younger than 18, 1987 to 2012), 5-year probability of overall survival rose from 49% to 76%, while EFS stayed at about 50% from 1993; the improvement came mainly from salvage therapy and transplant [7].
CML. In IRIS (median follow-up 10.9 years), 10-year overall survival with imatinib was 83.3% and the complete cytogenetic response rate was 82.8% [9]. With any of the TKIs, 10-year EFS and OS exceed 90%. The best candidates for stopping a TKI have taken it for more than 3 to 5 years and are in DMR (MR4.5; BCR::ABL1 ≤0.0032%); about 50% relapse after stopping, relapse is about 10% after 5 years or more in DMR, and almost all respond again to the same TKI [10].
CLL. Generally not curable; median survival in trials from the 1970s to the 1990s was 8 to 12 years, and with BCR and BCL2 inhibitors median survival has not been reached after more than 10 years of follow-up. Observation is the accepted approach in asymptomatic disease; in a meta-analysis of six trials of immediate versus deferred chlorambucil, 10-year survival did not differ [11]. In CLL14 (12 cycles of venetoclax and obinutuzumab vs chlorambucil and obinutuzumab in patients with coexisting conditions), median PFS was 76.2 vs 36.4 months (HR 0.40) and 6-year survival was 78.7% vs 69.2% (HR 0.69; P=0.052) [12].
Scientific evidence
Scientific evidence
4 itemsImproved Survival for Children and Adolescents With Acute Lymphoblastic Leukemia Between 1990 and 2005: A Report From the Children's Oncology Group
Long-Term Outcomes of Imatinib Treatment for Chronic Myeloid Leukemia
Retinoic acid and arsenic trioxide for acute promyelocytic leukemia
Venetoclax-obinutuzumab for previously untreated chronic lymphocytic leukemia: 6-year results of the randomized phase 3 CLL14 study
Related cancer types
Related questions
References
12 referencesShow all references, 4 with a study cardClose the reference list
Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.
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- 9Long-Term Outcomes of Imatinib Treatment for Chronic Myeloid Leukemia
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- 12Venetoclax-obinutuzumab for previously untreated chronic lymphocytic leukemia: 6-year results of the randomized phase 3 CLL14 study
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