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In AML, Time From Diagnosis to Treatment Not Linked to Survival

No difference seen in unadjusted two-year OS rates for TDT of zero to five, six to 10, 11 to 15, >15 days

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THURSDAY, June 4, 2020 (HealthDay News) -- For patients with newly diagnosed acute myeloid leukemia, the time from diagnosis to treatment start (TDT) for intensive treatment is not associated with overall survival, according to a study published online June 4 in Blood.

Christoph Röllig, from Universitätsklinikum Dresden in Germany, and colleagues selected 2,263 acute myeloid leukemia patients with intensive induction treatment and minimum follow-up time of 12 months to examine the influence of TDT on remission, early death, and overall survival. Patients with TDT >50 days were excluded from the analysis.

The researchers found that the median TDT was three days. For TDT of zero to five, six to 10, 11 to 15, and >15 days, the unadjusted two-year overall survival rates were 51, 48, 44, and 50 percent, respectively. The hazard ratio for TDT as a continuous variable was 1.00 (95 percent confidence interval, 0.99 to 1.01; P = 0.617) in a multivariable analysis accounting for established prognostic variables. No significant between-group differences were seen when overall survival was analyzed separately and stratified for age ≤60 versus >60 years and for high versus low initial white blood cell count.

"In the majority of patients, it seems safe to wait for the diagnostic results in order to assign the patient to the correct subgroup and select the appropriate treatment, rather than using the historic one-size-fits-all chemotherapy approach," Röllig said in a statement. "We think a potential deterioration in prognosis, if it exists at all, will be much smaller than the clinical benefit a patient would gain by receiving the appropriate novel treatment."

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