Effect of time of admission to treatment initiation on outcomes of patients with acute myeloid leukemia: a tertiary care referral center experience

Background The time from diagnosis of acute myeloid leukemia (AML) to initiation of treatment could affect patient outcomes, but findings from previous studies have been mixed.

Objective To analyze the impact of the time from adm ission to treatment initiation (TAT) on overall survival (OS) and event-free survival (EFS) in patients who are newly diagnosed with AML.

Methods A retrospective review of the records of all newly diagnosed AML patients treated at the Oklahoma University Health Sciences Center from January 2000 through June 2015 was conducted. Inclusion criteria also included age ≥18 years and available insurance data. Data on patient characteristics, laboratory values, pathology, treatment, response, and survival were obtained from the electronic medical records.

Results In all, 154 patients were divided into 2 groups: those with a TAT of 0-4 days (n = 109) and those with a TAT of >4 days (n = 45). The median OS of the TAT 0-4 days group and the TAT >4 days group was 1.3 years and 0.57 years, respectively(P = .0207), and the median EFS for the groups was 1.21 years and 0.57 years, respectively (P = .0392). That association remained significant in a multivariate analysis adjusting for age, white blood cell count, molecular risk group, and undergoing allogeneic stem cell transplant.

Limitations Study limitations include a small sample size and a short median follow-up time.

Conclusion Patients with AML who are treated more than 4 days after admission have a lower OS and EFS compared with patients treated within 0-4 days of admission.

Funding/sponsorship None

 

Accepted for publication September 13, 2018
Correspondence Sami Ibrahimi, MD; Sami-Ibrahimi@ouhsc.edu
Disclosures Cherry is on the advisory board of Gilead. The remaining authors report no disclosures or conflicts of interest.
Citation JCSO 2018;16(5):e188-e193

©2018 Frontline Medical Communications
doi https://doi.org/10.12788/jcso.0428