JCT  Vol.4 No.5 , July 2013
Time Elapsed from AML Diagnosis to Induction Chemotherapy Affects Overall Survival
Abstract: We aimed to study the effect of elapsed time from AML diagnosis to treatment (TDT) on OS in a group of patients from public Hospital in Brazil. 41 AML (23 M, 18 F, 41 yrs, 18 - 84 yrs, from 2001 to 2004). There were 38 de novo AML and 3 secondary, median TDT was 6 days (range 1 - 82 d); the young ones were treated earlier than old ones (TDT 4 days vs 11, p = 0.07). Longer TDT (>10 d) was associated with worse CR rates (p = 0.02) and OS (p = 0.04). When patients were categorized into TDT from 1 - 4 d (I) vs >5 (II), those from I presented better OS than II (p = 0.004). When TDT was longer than 7 days OS decreased even more. Hb was higher in patients with TDT I vs II (8.3 vs 7.5 g/dL, p = 0.03) but WBC (p = 0.34) and platelet count (p = 0.75) were not different. Patients with TDT of 10 d were younger than TDT > 10 d (median age 41 vs 70 yrs, p = 0.001). The OS was 15.1% in 2 yrs and 8.6% in 7 yrs. Our data suggest longer TDT, when analyzed continuously, predicted for lower CR rates and OS rates.
Cite this paper: L. Pelloso, S. Rohr, M. Yamamoto and M. Chauffaille, "Time Elapsed from AML Diagnosis to Induction Chemotherapy Affects Overall Survival," Journal of Cancer Therapy, Vol. 4 No. 5, 2013, pp. 957-960. doi: 10.4236/jct.2013.45108.

[1]   D. Grimwade, H. Walker, G. Harrison, et al., “The Predictive Value of Hierarchical Cytogenetic Classification in Older Adults with Acute Myeloid Leukemia (AML): Analysis of 1065 Patients Entered into the United Kingdom Medical Research Council AML 11 Trial,” Blood, Vol. 98, No. 5, 2001, pp. 1312-1320. doi:10.1182/blood.V98.5.1312

[2]   P. D. Kottaridis and R. E. Gale, Frew “The Presence of a FLT3 Internal Tandem Duplication in Patients with Acute Myeloid Leukemia (AML) Adds Important Prognostic Information to Cytogenetic Risk Group and Response to the First Cycle of Chemotherapy: Analysis of 854 Patients from the United Kingdom Medical Research Council AML 10 and 12 Trials,” Blood, Vol. 98, No. 6, 2001, pp. 1752-1759. doi:10.1182/blood.V98.6.1752

[3]   M. A. Sekeres, P. Elson, M. E. Kaylacio, et al., “Time from Diagnosis to Treatment Initiation Predicts Survival in Younger, But Not Older, Acute Myeloid Leukemia Patients,” Blood, Vol. 113, No. 1, 2009, pp. 28-36. doi:10.1182/blood-2008-05-157065

[4]   E. M. Fagundes, V. Rocha and A. B. Glória, et al., “De Novo Acute Myeloid Leukemia in Adults Younger than 60 Years of Age: Socioeconomic Aspects and Treatment Results in a Brazilian University Center,” Leukemia & Lymphoma, Vol. 47, No. 8, 2006, pp. 1557-1564. doi:10.1080/10428190600627055

[5]   W. Pulcheri, N. Spector, M. Nucci, et al., “The Treatment of Acute Myeloid Leukemia in Brazil: Progress and Obstacles,” Haematologica, Vol. 80, No. 2, 1995, pp. 130-135.

[6]   L. A. Pelloso, M. de L. Chauffaille, F. S. Ghaname, et al., “Karyotype in Acute Myeloid Leukemia: Importance and Type of Aberrations in 30 Patients at Diagnosis,” Revista da Associa??o Médica Brasileira, Vol. 49, No. 2, 2003, pp. 150-155. doi:10.1590/S0104-42302003000200032

[7]   C. A. Rodrigues, M. L. Chauffaille, L. A. Pelloso, et al., “Acute Myeloid Leukemia in Elderly Patients: Experience of a Single Center,” Brazilian Journal of Medical and Biological Research, Vol. 36, No. 6, 2003, pp. 703-708. doi:10.1590/S0100-879X2003000600004

[8]   A. Kanamaru, Y. Takemoto, M. Tanimoto, H. Muramaki, N. Asou, T. Kobayashi, K. Kuriyama, E. Ohmoto, H. Sakamaki, K. Tsubari, A. Hiraoka, O. Yamada, H. Oh, K. Saito, S. Matsuda, K. Minato, T. Ueda, O. Ohno and Japan Study Group, “All Trans Retinoic Acid for the Treatment of Newly Diagnosed Acute Promyelocytic Leukemia,” Blood, Vol. 85, No. 5, 1995, pp. 1202-1206.

[9]   F. R. Appelbaum, H. Gundacker, D. R. Head, et al., “Age and Acute Myeloid Leukemia,” Blood, Vol. 107, No. 9, 2006, pp. 3481-3485. doi:10.1182/blood-2005-09-3724

[10]   G. Juliusson, et al., “Most 70-to 79-Year-Old Patients with Acute Myeloid Leukemia Do Benefit from Intensive Treatment,” Blood, Vol. 117, No. 12, 2011, pp. 3473-3474. doi:10.1182/blood-2010-11-321737