Acute myeloid leukemia (AML) is an aggressive form of cancer that affects a type of white blood cell called myeloid cells. Ordinarily, myeloid cells help to fight infection and prevent tissue damage. In AML, the myeloid cells are defective and multiply rapidly, preventing the production of healthy blood cells.

Acute myeloid leukemia starts in blood-forming cells within the bone marrow. However, it quickly moves into the blood. It can also spread to other parts of the body, such as the lymph nodes, liver, spleen, and central nervous system.

As the risk of AML increases with age, this article looks at the average life expectancy of older adults with AML. We also present survival rate statistics by age and the factors affecting survival. Finally, we outline the treatment options for older adults living with AML.

Hands holding cup and saucer.Share on Pinterest
Thanasis Zovoilis/Getty Images

Survival rate statistics are general statistics that researchers have collated from large groups of people over many years. Doctors use them to provide a prognosis for specific cancers at specific stages.

Survival rate statistics cannot predict how long a person will live following a cancer diagnosis. This may be due to several factors, including:

  • individual responses to treatment
  • changes to existing cancer treatments
  • the availability of new cancer treatments

Survival rate statistics may include the following data:

  • Cancer-specific survival: The percentage of people who have not died from a cancer during a certain time period. Medical professionals frequently refer to 5-year survival rates.
  • Relative survival: The percentage of people with cancer who survived during a specific period, compared to the percentage of people who did not have cancer.
  • Overall survival: The percentage of people with cancer who have not died from any cause during a specific period.
  • Disease-free survival: The percentage of people who have no signs of cancer during a specific period following cancer treatment. Medical professionals sometimes refer to this as “recurrence-free survival.”

A doctor can use cancer survival statistics to help inform a person about their individual prognosis. A person may receive a favorable prognosis if there is good evidence of effective treatments for their cancer type and stage.

Contrastingly, a person may receive a poor prognosis if statistics show the cancer to be particularly aggressive or if treatment only achieves short-term disease remission.

The 5-year relative survival rate (RSR) for people with acute myeloid leukemia (AML) is 29.5%. This means that less than 1 in 3 people who receive a diagnosis of AML will survive more than 5 years following their diagnosis.

However, this figure represents all people with AML, and survival rates decrease significantly as age progresses. The average age at diagnosis is 68 years.

According to the American Cancer Society (ACS), 2 in 3 people who receive chemotherapy for AML experience disease remission.

Survival rate and remission depend on several factors, including:

  • the person’s age
  • how advanced the AML is
  • whether there are genetic or chromosomal risk factors present

People over the age of 60 are more likely to have chromosomal changes that will affect their prognosis, and older people are also less likely to respond well to treatment.

A 2020 analysis investigated the impact of age on AML outcomes in 180 adults with the disease. The study reported the following 2-year disease-free survival rates according to age:

Age2-year Survival rate
under 4047.7%
41 – 6023.6%
over 6111.7%

In England, between 2004-2016, researchers reported the following 5-year RSRs for AML using narrower age margins:

Age5-year Survival rate
Under 40More than 50%
40 – 4945%
50-5925%
60-6915%
70-795%
80 and over2%

The National Cancer Institute estimates that 0.5% of American men and women will receive a diagnosis of AML at some point in their life. In 2018, they estimated there to be around 66,988 people with AML living in the United States. In 2021, they estimated around 20,240 new cases of AML.

The ACS states that the following factors may increase a person’s risk of developing AML:

  • Aging: Although AML can occur at any age, the risk increases as a person gets older.
  • Being male: AML is more common in men than in women.
  • Family history: A person is more likely to develop AML if they have a sibling or parent with the disease.
  • Smoking: Carcinogenic substances in tobacco smoke can spread to cells beyond the lungs, via the bloodstream.
  • Exposure to certain chemicals: Includes chemicals people us in manufacturing, such as benzene and formaldehyde.
  • Exposure to chemotherapy drugs: Includes alkylating drugs and topoisomerase II inhibitors.
  • Radiation exposure: Work accidents or radiation treatment for cancer may expose a person to high doses of radiation.
  • Blood disorders: Includes low blood counts, as well as disorders, such as polycythemia vera.
  • Genetic conditions: Includes certain genetic syndromes, such as Down syndrome or neurofibromatosis type 1.

The ACS also mentions unproven or uncertain risk factors, such as exposure to gasoline, pesticides, or electromagnetic fields. More research is necessary to determine whether these factors increase the risk of AML.

A 2020 report investigating AML risk mentions high body mass index (BMI) as a risk factor for the disease. It also notes that people from low-income backgrounds are more likely to face exposure to harmful chemicals compared to people from high-income backgrounds.

The main treatment for AML is induction chemotherapy to lower the number of leukemia cells in the body. Doctors may prescribe or adjust chemotherapy drugs and dosages according to the following:

  • a person’s age
  • whether the person has heart problems
  • whether the myeloid cells show genetic or chromosomal changes

Doctors may also recommend radiotherapy if AML has spread to the brain or spinal cord.

Following chemotherapy, most people need antibiotics and blood transfusions to improve their blood count and recovery.

A doctor will also conduct a bone marrow biopsy to check for cancerous cells. If no more than 5% of bone marrow cells are cancerous, the doctor will declare the person to be in remission. If more than 5% of bone marrow cells are cancerous, the doctor may recommend additional chemotherapy or a stem cell transplant.

Following successful chemotherapy, doctors may recommend a post-remission therapy called consolidation treatment. This treatment helps to kill any remaining cancer cells in the body. Drug types and dosages will depend partly on a person’s age.

People who are older or unwell may be unable to tolerate the same medications or dosages as people who are younger and otherwise healthy. Doctors will take multiple factors into account when deciding on consolidation therapy.

Some people who are older or unwell may decide not to proceed with chemotherapy or medication. Instead, they may opt for supportive care, which involves treating AML symptoms and complications. Supportive care focuses on keeping the person comfortable rather than treating the cancer.

A doctor will be able to advise people who are unsure how to proceed with their care. However, the American Society of Hematology recommends opting for treatment over supportive care wherever possible.

Acute myeloid leukemia (AML) is an aggressive form of cancer that affects white blood cells called myeloid cells. Healthy myeloid cells help to fight infections and prevent tissue damage. In AML, the myeloid cells are defective and multiply rapidly, preventing the production of healthy blood cells.

Survival rates for AML fall significantly as age progresses. While chemotherapy and other interventions can treat AML, a person’s age may affect how well they tolerate and respond to treatment.

Sometimes, people with AML forego treatment to fight cancer, opting instead for supportive care to treat any symptoms and complications. A doctor can help a person reach a decision about an appropriate treatment plan. However, people should generally aim for treatment over supportive care, wherever possible.