refractory Myeloid Leukemia

What Is Refractory Myeloid Leukemia?

Refractory myeloid leukemia (RML) is a type of leukemia found in adults and children. It is a form of acute myeloid leukemia (AML) which is resistant to chemotherapy and has a poor prognosis. It is also known as therapy-resistant or refractory myeloid leukemia.

RML is characterized by a rapid progression of the disorder, high levels of white blood cells, and enlarged lymph nodes or spleen. It can often present with cytopenia, decreased bone marrow cellularity, and chromosomal abnormalities. There is no known single cause of RML; however, it is believed to be a result of genetic and environmental factors.

Diagnosis of RML

Diagnostic criteria for RML vary among different clinical centers but are mainly based on the patient's clinical presentation. It can be difficult to diagnose because it often shares similar symptoms with other types of leukemia. Diagnosis is usually based on an analysis of bone marrow, including cytogenetics, immunophenotyping, and cytochemical methods.

Treatment for RML

Treatment for RML is limited due to the rapid progression of the disorder. Treatment is aimed at decreasing the number of blasts in the bone marrow, improving overall survival rates, and preventing complications. Commonly used treatments include:

  • Chemotherapy
  • Drug therapy, such as hydroxyurea or interferon
  • High-dose chemotherapy with stem cell transplantation
  • Radiation therapy

No single therapy can be considered an appropriate, universal first-line treatment for RML. It is important to discuss all therapeutic options and their potential benefits and risks with the treating physician.


The outlook for RML is generally poor due to its rapid disease progression. Long-term survival rates vary based on the patient's age and overall health, as well as the type of treatment received. The median survival rate is approximately 4-5 months for patients with RML. With aggressive treatment, however, some patients can achieve long-term remission or even cure.