Blood: Does the interval between diagnosis and the start of treatment affect the prognosis of newly diagnosed AML patients?

Since the prognosis of acute leukemia without treatment is poor, it is recommended that patients with newly diagnosed acute myeloid leukemia (AML) begin treatment immediatelyIn a new article published in the journal Blood, researchers looked at the relationship between time and prognosis from diagnosis to the start of treatment (TDT) using a wealth of real data from the SAL-AML registry in GermanyAll registered non-APL patients (2263) received intensive induction therapy for a minimum follow-up period of 12 monthsIn the single-variable analysis, the researchers analyzed the effects of TDT on mitigation, early death, and total survival (OS) for each delayed day of treatment, divided into 0-5, 6-10, 11-15 and 15-day groups of TDT treatment, and adjusted the effects of known prognosis variables on resultsThe median TDT is 3 days (IQR 2-7)The unadjusted two-year overall survival rates (OS) for the 0-5, 6-10, 11-15 and 15-day groups were 51%, 48%, 44% and 50% respectively (p-0.211)The risk ratio (HR) of TDT as a continuous variable is 1.00 (p-0.617) in the Cox regression analysis of the multi-variable Cox regression that considers the explicit prognosis variableWhen the layered analysis was performed based on age (s.60 vs60 years old) and the initial WBC count (high vs low), there was no significant difference in OS between TDT groupsIn summary, this study shows that TDT has nothing to do with the patient's survival prognosisAs AML strengthens the stratification of first-line treatment, TDT data suggest that waiting for laboratory testresults such as genetics to assign patients with stable conditions to the best treatment options may be a viable approach