Is acute myeloid leukemia M5 type severe?

Generally, acute leukemia M5 subtype is one of the more aggressive forms among acute myeloid leukemias, with a generally severe clinical course. However, prognosis varies significantly depending on factors such as patient age, chromosomal abnormalities, and timing of treatment. Detailed analysis is as follows:

From the perspective of disease characteristics, M5-type leukemia cells (monocytic cells) proliferate rapidly and tend to infiltrate extramedullary tissues, such as causing gingival swelling, skin bruising, or central nervous system involvement. It is often accompanied by high white blood cell counts, severe anemia, and thrombocytopenia. Patients are prone to life-threatening complications such as infections and bleeding early in the disease course. Without timely treatment, the natural course of the disease typically lasts only several weeks to months.

Regarding prognostic stratification, younger patients (<60 years) without high-risk chromosomal abnormalities who respond well to induction chemotherapy may achieve a 5-year disease-free survival rate of 40%–60% with standardized treatment. In contrast, older patients (>60 years), especially those with multiple comorbidities or high-risk genetic mutations, often have poor treatment tolerance, lower remission rates, and a 5-year survival rate frequently below 20%, indicating a more ominous prognosis.

In summary, acute leukemia M5 should be recognized as a serious condition, but it is not an "incurable disease." Once diagnosed, prompt individualized treatment at a hematology specialty center is essential. Younger eligible patients should actively consider hematopoietic stem cell transplantation to improve outcomes, avoiding disease progression due to delayed or abandoned treatment.