Impact of Chemotherapy Delay on Overall Survival for AML with IDH1/2 Mutations: A Study in Adult Chinese Patients |
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| Authors: | Jing-Han Wang Qi Guo Zhi-Xin Ma Qiu-Ling Ma Meng-Xia Yu Xiu-Feng Yin Sha-Sha Lu Hong-Qiong Xie Yue-Hong Jiang Dan Shen Li-Ya Ma Hui Shi Wen-Juan Yu Ye-Jiang Lou Ying Li Min Yang Gai-Xiang Xu Li-Ping Mao Jian-Hu Li Huan-Ping Wang Dong-Mei Wang Ju-Ying Wei Hong-Yan Tong Jian Huang Jie Jin |
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| Affiliation: | 1. Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.; 2. Key Laboratory of Hematopoietic Malignancies, Zhejiang Province, Hangzhou, Zhejiang, PR China.; 3. Department of Nephrology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.; RWTH Aachen University Medical School, GERMANY, |
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| Abstract: | The effect of time from diagnosis to treatment (TDT) on overall survival of patients with acute myeloid leukemia (AML) remains obscure. Furthermore, whether chemotherapy delay impacts overall survival (OS) of patients with a special molecular subtype has not been investigated. Here, we enrolled 364 cases of AML to assess the effect of TDT on OS by fractional polynomial regression in the context of clinical parameters and genes of FLT3ITD, NPM1, CEBPA, DNMT3a, and IDH1/2 mutations. Results of the current study show IDH1/2 mutations are associated with older age, M0 morphology, an intermediate cytogenetic risk group, and NPM1 mutations. TDT associates with OS for AML patients in a nonlinear pattern with a J shape. Moreover, adverse effect of delayed treatment on OS was observed in patients with IDH1/2 mutations, but not in those with IDH1/2 wildtype. Therefore, initiating chemotherapy as soon as possible after diagnosis might be a potential strategy to improve OS in AML patients with IDH1/2 mutations. |
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