SEARCH:   Advanced

Blood, 1 January 2009, Vol. 113, No. 1, pp. 28-36. Prepublished online as a Blood First Edition Paper on September 30, 2008; DOI 10.1182/blood-2008-05-157065. This Article Full Text (PDF) All Versions of this Article: blood-2008-05-157065v1 113/1/28    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Sekeres, M. A Articles by Estey, E. Search for Related Content PubMed PubMed Citation Articles by Sekeres, M. A Articles by Estey, E. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted May 19, 2008 Accepted August 18, 2008 Time from diagnosis to treatment initiation predicts survival in younger, but not older, acute myeloid leukemia patients Mikkael A Sekeres*, Paul Elson, Matt E Kalaycio, Anjali S. Advani, Edward A. Copelan, Stefan Faderl, Hagop M Kantarjian, and Elihu Estey Hematologic Oncology and Blood Disorders, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, United States M.D. Anderson Cancer Center, Houston, TX, United States Fred Hutchinson Cancer Research Center, Seattle, WA, United States * Corresponding author; email: sekerem{at}ccf.org. Acute myeloid leukemia (AML) is considered an oncologic emergency. Delaying induction chemotherapy until molecular testing results return, to individualize therapy, may benefit some patients, but harm others. We examined the effect of time from AML diagnosis to treatment (TDT) on complete remission (CR) and overall survival (OS), using patient characteristics available at diagnosis. Regression models were applied to older (>60 years) and younger (<60 years) adults, controlling for age, baseline WBC, secondary AML (sAML), and performance status. Patient median age was 60 years (range, 17-87), pre-treatment WBC 5.0/mm3 (0.3-48.6), TDT 4 days (1-78), and 45% had sAML. Cytogenetic risk distribution was: favorable 8%, intermediate 66%, unfavorable 26%. CR rate was 67% and median OS was 68 weeks in patients <60 years; 55% and 33 weeks in patients >60, respectively. In univariate and multivariate analyses, longer TDT was associated with worse CR and OS in younger (univariate: p<0.001 in both; multivariate: p<0.001 and p=0.001, respectively), but not older patients (univariate: p=0.45, p=0.19; multivariate: p=0.63, p=0.30, respectively). Results did not change with inclusion of cytogenetic data, or in risk group subsets. AML therapy should be initiated immediately in younger patients. Delaying treatment does not seem harmful in older patients, allowing individualized approaches. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

	Copyright © 2008 by American Society of Hematology         Online ISSN: 1528-0020