Acute Lymphocytic Leukemia (ALL): Your Chances for Recovery (Prognosis)

What is a prognosis?

Prognosis is the word your healthcare team may use to describe your likely outcome from your leukemia and its treatment. A prognosis is a calculated guess. It’s a question many people have when they learn they have cancer.

Making a choice

The decision to ask about your prognosis is a personal one. It’s up to you to decide how much you want to know. Some people find it easier to cope and plan ahead when they know their prognosis and the statistics for how well a treatment might work. Other people find statistics confusing and frightening. Or they might think statistics are too general to be useful.

A doctor who is most familiar with your health is in the best position to discuss your prognosis with you and explain what the statistics may mean in your case. At the same time, you should keep in mind that your prognosis can change. Cancer and cancer treatment outcomes are hard to predict. For instance, a favorable prognosis (which means you’re likely going to do well) can change if the ALL keeps growing or doesn’t respond to treatment. An unfavorable prognosis can change, too. This can happen if treatment controls the ALL so it doesn’t grow more.

What goes into a prognosis

When figuring out your prognosis, your doctor will consider all the things that could affect the cancer and its treatment. Your doctor will look at risk estimates about the exact type of ALL you have. These estimates are based on what results researchers have seen over decades in many people with the same type of ALL.

If your ALL is likely to respond well to treatment, your doctor will say you have a favorable prognosis. If your leukemia is likely to be hard to control, your prognosis may be less favorable. In this case, the leukemia may shorten your life. It’s important to keep in mind that a prognosis states what’s likely or probable. It is not a prediction of what will definitely happen. No doctor can be fully certain about an outcome.

Your prognosis depends mainly on: 

  • Your age and overall health

  • The sub-type of ALL

  • Gene or chromosome changes in the leukemia cells

  • Your white blood cell (WBC) count at the time you’re diagnosed

  • Whether you have ALL cells in your brain and spinal cord (called CNS or central nervous system involvement) or other places outside of your bone marrow

  • If you have a bad infection when you are diagnosed

  • If you've had chemotherapy for another cancer in the past

  • How well and how fast your ALL responds to treatment

Understanding survival rates

Survival rates show how many people live for a certain length of time after being told they have cancer. Most often, the numbers used refer to the 5-year survival rate. That’s how many people live at least 5 years after being diagnosed. 

People who have so signs of ALL after 5 years are usually cured. 

What are the survival rates for ALL?

ALL survival rates vary a lot based on the leukemia sub-type and the factors listed above. The relative 5-year survival rate for people diagnosed with ALL is 71%. This number is adjusted for the fact that some people with ALL will die from causes other than ALL. It's based on people who were diagnosed between 2005 and 2011. Many new and better treatments for ALL have become available in recent years. So the prognosis for people diagnosed with ALL today is probably better. In fact, treatment advances have almost doubled the 5-year survival rate for leukemias as a combined group. And new treatments are regularly developed. 

Talking with your healthcare provider 

You can ask your healthcare provider about survival rates and what you might expect. But remember that statistics are based on large groups of people treated at least 5 years ago. They can’t be used to say what will happen to you. No two people are exactly alike. Treatment and how well people respond to treatment vary.