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Medline ® Abstract for Reference 3

of 'Induction therapy for acute myeloid leukemia in younger adults'

3
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Time from diagnosis to intensive chemotherapy initiation does not adversely impact the outcome of patients with acute myeloid leukemia.
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Bertoli S, Bérard E, Huguet F, Huynh A, Tavitian S, Vergez F, Dobbelstein S, Dastugue N, Mansat-De Mas V, Delabesse E, Duchayne E, Demur C, Sarry A, Lauwers-Cances V, Laurent G, Attal M, Récher C
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Blood. 2013 Apr;121(14):2618-26. Epub 2013 Jan 30.
 
In acute myeloid leukemia (AML), new strategies assess the potential benefit of genetically targeted therapy at diagnosis. This implies waiting for laboratory tests and therefore a delay in initiation of chemotherapy. We studied the impact of time from diagnosis to treatment (TDT) on overall survival, early death, and response rate in a retrospective series of 599 newly diagnosed AML patients treated by induction chemotherapy between 2000 and 2009. The effect of TDT was assessed using multivariate analysis. TDT was analyzed as a continuous variable using a specific polynomial function to model the shape and form of the relationship. The median TDT was 8 days (interquartile range, 4-16) and was significantly longer in patients with a white blood cell count (WBC)<50 Giga per liter (G/L) (P<.0001) and in older patients (P = .0004). In multivariate analysis, TDT had no impact on overall survival (P = .4095) compared with age>60 years, secondary AML, WBC>50 G/L, European LeukemiaNet risk groups, and Eastern Cooperative Oncology Group performance status. Furthermore, TDT was not associated with response rate and early death. Thus, waiting a short period of time for laboratory tests to characterize leukemias better and design adapted therapeutic strategies at diagnosis seems possible.
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Service d'Hématologie, Centre Hospitalier Universitaire de Toulouse, Hôpital Purpan, Toulouse, France;
PMID