New Delhi: At 40, many envision a peak career phase, supporting families and shaping futures. But for a growing number of Indians, this milestone is being marred by an unexpected adversary — Acute Myeloid Leukemia (AML), an aggressive and fast-progressing form of blood cancer traditionally associated with older adults.
Each year, the city reports at least 3,000 cases of AML, with doctors observing a worrying increase in diagnoses among individuals aged 30 to 40. The troubling shift in younger populations creates a complex interplay of clinical, financial, and psychosocial challenges. To explore this rise, Rashmi Mabiyan Kaur from ETHealthworld spoke to Dr. Ranjit Sahoo, Additional Professor, Medical Oncology, AIIMS, and Dr. Dharma Chaudhary, Vice Chairman – Haemato Oncology & BMT, BLK Super Speciality Hospital.
AML originates in the bone marrow and rapidly crowds out healthy blood cells. While it has long been considered a disease of the elderly in the West, in India, a significant portion of AML patients are in their 30s and 40s — a working, earning demographic.
“This is a stem cell disease. The only cure remains a stem cell transplant,” said Dr. Chaudhary. “If we just give chemotherapy without planning for a transplant or adequate diagnostics, patients will relapse.”
This younger age group, though potentially more curable, faces hurdles such as delayed diagnosis, rapid disease progression, and a healthcare system unprepared for aggressive early intervention.
Younger patients with AML, if diagnosed early, can be cured in up to 60 per cent of cases, according to Dr. Sahoo.
“Just by age, not even accounting for genomics, pediatric and young adult AML patients have a higher curability,” he emphasized. “But we’re often seeing them too late, wherein they are already infected or in poor general condition that reduces their odds significantly.”
Timely diagnosis and treatment are crucial. Standard care involves induction chemotherapy followed by consolidation therapy and, in high-risk cases, a bone marrow transplant (BMT). Genetic profiling now enables doctors to determine whether chemotherapy alone is sufficient or if BMT is necessary.
However, India’s fragmented healthcare infrastructure means that not all patients get access to advanced diagnostics, proper chemotherapy regimens, or transplant centers — a combination vital for long-term remission.
In India, the financial toxicity of AML treatment is staggering. As Dr. Chaudhary explained, the total cost from diagnosis to transplant ranges between ₹20 to ₹30 lakh in private settings. Government hospitals provide treatment between ₹50,000 to ₹2 lakh — but have limited capacity and long waiting lists.
Compounding the crisis is the lack of adequate insurance coverage. Most commercial policies provide limited payouts, often exhausted during the first cycle of chemotherapy.
“Patients either need to be self-funded or covered under government schemes like CGHS or ESI,” Dr. Sahoo noted. Experts stated that middle-class patients fall through the cracks. They often abandon treatment midway, not because it isn’t working, but because it is unaffordable.
AML is curable, especially in India’s young but only if caught and treated in time. “Every 40-year-old with AML is curable on paper,” Dr. Sahoo asserted.
Beyond biology and bank accounts, AML in younger individuals poses stark social repercussions. At 40, many are sole breadwinners. A sudden diagnosis of AML means job loss, financial ruin, and emotional breakdown of the entire household.
Moreover, the urgency of care needed, from rapid transfusions to complex therapies, requires family, community, and logistical support that is hard to marshal in the Indian context. Platelet donations, for instance, must be arranged quickly and repeatedly.
As India battles a rising tide of non-communicable diseases, AML among younger adults demands urgent attention. It’s not just a clinical challenge — it’s a call for systemic reform, financial inclusion, and compassionate care, urged the experts.
For now, hope rests on early diagnosis, integrated care, and stronger policy support because behind every AML diagnosis in a young adult is not just a patient, but a family, a future, and a life waiting to be saved.
The experts were speaking at the AML awareness session organized by AbbVie India.
