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It’s officially been five years since the launch of #KnowAML World Awareness Day. To mark this occasion, we want to highlight the high incidence of AML cases in the elderly and raise awareness of the increasingly lower 5-year survival rates in this population too. Additionally, we’ll be taking a snapshot of the past 5 years since the first Know AML Day and seeing how far treatments have come.
High incidence and low survival rates
Each year, more than 4 in 10 new AML cases (42%) in the UK are in people aged 75 and over and over half of patients with AML are already over 65 years old [1]. As age increases, survival rates in older patients drop, as demonstrated below:
The rising incidence of AML presents unique challenges in treating an ageing population and, whereas much progress has been made in treating younger adults with intensive chemotherapy over the last 30 years, the prognosis for AML in the older patients remains poor.
Many patients, particularly if they are older than age 75, receive no specific anti-AML therapy. Additionally, out of those who are put on intensive chemotherapy, fewer older patients achieve a complete remission compared to younger patients, and there is a higher relapse risk.
Shifts in treatment patterns: A 5-year snapshot
However, the last 5 years have seen shifts in treatment patterns for older patients with AML.
According to Oncology Nurse Advisor, among patients receiving frontline treatment, compared with those given conventional therapy, were more likely to be older. They also had fewer hospital admissions and inpatient days [2].
And thankfully, there are exciting times ahead for older patients with acute myeloid leukaemia thanks to charities like Leukaemia Care who campaign for new treatment options for AML patients.
For example, this year the National Institue for Health and Care Excellence (NICE) have made recommendations of venetoclax in combination with azacitidine to become available as an NHS treatment option for AML in England. Leukaemia Care provided a submission that outlined the value of this treatment to patients which led to the approval. This combination of treatments has been approved for people diagnosed with leukaemia who are unable to have intensive chemotherapy, such as elderly patients [3].
“There are many benefits to this drug, firstly it seems to be very swift and effective. The patient can stay at home and self-administer and carry out most normal activities. Whilst I decided not to return to work until treatment had finished, I felt that I could have managed a partial return.” AML patient on venetoclax and azacitidine
Treating AML in the older population remains a significant challenge and will become an increasingly common one over the next several years as the population ages. However, as evidenced above, charities like Leukaemia Care are advocating for this population and will ensure that treatment options continue to improve.
How the advocacy team can help AML patients
In addition to our involvement in the appraisal process for new treatments, the advocacy team can support AML patients and their families directly with a range of queries throughout their diagnosis and treatment.
If you have recently been diagnosed with AML and you aren’t sure what your treatment options are, we can look into this for you and give you some more information about treatments that are currently available. Sometimes this can take a lot of research, work which we can take off your plate. If your consultant has recommended a particular treatment, we can talk this through with you at your own pace and give you some more details about the treatment. Some patients find it comforting to learn more about their treatment before discussing it with their consultant again, as it can help to break down some of the medical jargon that the doctors may use during your appointments. We provide a safe space to help you weigh up pros and cons of suggested treatments or plans of action, away from the time constraints of appointments.
As the family or friend of someone diagnosed with AML, it can be really hard to understand what is happening to your loved one, especially if you are only hearing things second-hand. It’s important to know that our advocacy team can talk to anyone affected by leukaemia, not just the patient themselves.
Unfortunately, some patients may not be suitable for conventional treatment, or they may want to explore their options further by looking into clinical trials. In addition to helping you to understand what a trial is and how they work, we can assist you to identify potential trials that may be suitable for you and provide more information about them. This information may encourage you to have a discussion with your consultant about the possibility of taking part in the trial, and they would be able to discuss this with you further.
This is just a snapshot of what our advocacy team can support patients and their families with. You can read more about what the team can help with here.
To get in touch, please email advocacy@leukaemiacare.org.uk
And finally…do you know the signs and symptoms of leukaemia?
Leukaemia has one of the highest rates of emergency diagnosis, with 37% of cases being diagnosed in an emergency setting so it’s vital to Spot Leukaemia and contact a GP early. In fact, 70-79-year-olds with AML are almost 3 times more likely to survive after 12 months if they go down the two-week wait referral pathway, as opposed to emergency diagnosis [4].
Do you know the signs and symptoms of leukaemia?
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