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AML cancer-pls advice

My father has been diagnosed with acute myeloid leukemia in August. He has been given azacitidine based induction chemo for 4 cycels. He has a history of gum infection and hemeroids(ungerdone an operation 5yrs ago). He was in remission period for about a month and soon after he had a gum infection due to which there was a delay in admitting him for BMT. Once he was admitted we came to know his cancer relapsed,50%blasts were in blood and 80%in bone marrow. He was planned for 7+3(cytarabine and daunorubicin) chemo. After 15days of this chemo His cancer hasn't reduced much and meanwhile he started developing infection in form of hemroid for which he was operated. Now the blasts in the blood have gone up to 71% so there must be more cancer in his marrow. Doctors are guessing his body is not responding to chemo and they planned temozolomide based treatment and he's planned for allogenic BMT later.Is his condition bad? What are his chances to get better? If not, how much time do we have? :(
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Sharath Kumar K N
General Physician Mandya
Hello sir,,, acute myeloid leukemia (AML) is relatively rare but pretty bad condition. Prognosis (chance of getting better) depends on cytogenetic abnormality in leukemic cells(for example, t(8:21) abnormality has 5 year survival rate of 70% around 30% relapse rate, and - 5 or - 7 has only 15% 5yr survival rate and 75%-80% relapse rate. There are few other abnormalities too. No cytogenetic abnormality has intermediate prognosis) Chromosomal analysis of leukemic cells tells you what cytogenetic abnormality patient is having. Complete remission is possible with chemotherapy and marrow transplant if blood neutrophil and platelet count is more than or equal to 1000 and 10, 00, 000 per micro litre of blood respectively and no circulating blast cells, less than 5%blast cells in marrow, no extra medullary leukemia, and no Auer rods in blast cells . Older age is also bad prognostic factor and 5-10months average survival if cannot withstand chemotherapy. So talk to your oncologist to know more about cytogenetic and hence prognosis.
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