title: Impact of Chemotherapy Delay on Overall Survival for AML with IDH1/2 Mutations: A Study in Adult Chinese Patients.
abstract: The effect of time from diagnosis to treatment (TDT) on overall survival of patients with acute myeloid leukemia (AML) remains obscure. Furthermore, whether chemotherapy delay impacts overall survival (OS) of patients with a special molecular subtype has not been investigated. Here, we enrolled 364 cases of AML to assess the effect of TDT on OS by fractional polynomial regression in the context of clinical parameters and genes of FLT3ITD, NPM1, CEBPA, DNMT3a, and IDH1/2 mutations. Results of the current study show IDH1/2 mutations are associated with older age, M0 morphology, an intermediate cytogenetic risk group, and NPM1 mutations. TDT associates with OS for AML patients in a nonlinear pattern with a J shape. Moreover, adverse effect of delayed treatment on OS was observed in patients with IDH1/2 mutations, but not in those with IDH1/2 wildtype. Therefore, initiating chemotherapy as soon as possible after diagnosis might be a potential strategy to improve OS in AML patients with IDH1/2 mutations.
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China; Key Laboratory of Hematopoietic Malignancies, Zhejiang Province, Hangzhou, Zhejiang, PR China.
authors.forename: Jing-Han
authors.initials: JH
authors.lastname: Wang
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Guo
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Zhi-Xin
authors.initials: ZX
authors.lastname: Ma
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China; Key Laboratory of Hematopoietic Malignancies, Zhejiang Province, Hangzhou, Zhejiang, PR China.
authors.forename: Qiu-Ling
authors.initials: QL
authors.lastname: Ma
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Meng-Xia
authors.initials: MX
authors.lastname: Yu
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Xiu-Feng
authors.initials: XF
authors.lastname: Yin
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Sha-Sha
authors.initials: SS
authors.lastname: Lu
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Hong-Qiong
authors.initials: HQ
authors.lastname: Xie
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Yue-Hong
authors.initials: YH
authors.lastname: Jiang
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Shen
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Li-Ya
authors.initials: LY
authors.lastname: Ma
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Shi
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Wen-Juan
authors.initials: WJ
authors.lastname: Yu
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Ye-Jiang
authors.initials: YJ
authors.lastname: Lou
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Min
authors.initials: M
authors.lastname: Yang
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Gai-Xiang
authors.initials: GX
authors.lastname: Xu
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Mao
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Jian-Hu
authors.initials: JH
authors.lastname: Li
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Huan-Ping
authors.initials: HP
authors.lastname: Wang
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Dong-Mei
authors.initials: DM
authors.lastname: Wang
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China.
authors.forename: Ju-Ying
authors.initials: JY
authors.lastname: Wei
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China; Key Laboratory of Hematopoietic Malignancies, Zhejiang Province, Hangzhou, Zhejiang, PR China.
authors.forename: Hong-Yan
authors.initials: HY
authors.lastname: Tong
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China; Key Laboratory of Hematopoietic Malignancies, Zhejiang Province, Hangzhou, Zhejiang, PR China.
authors.forename: Jian
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, China; Key Laboratory of Hematopoietic Malignancies, Zhejiang Province, Hangzhou, Zhejiang, PR China.
authors.forename: Jie
authors.initials: J
authors.lastname: Jin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D044466:Asian People; D002681:China; D005260:Female; D006801:Humans; D007521:Isocitrate Dehydrogenase / Q000235:genetics*; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009154:Mutation; D000090243:Nucleophosmin; D011379:Prognosis; D013997:Time Factors; D055815:Young Adult
chemical_list: C000716967:NPM1 protein, human; D000090243:Nucleophosmin; C538784:IDH2 protein, human; D007521:Isocitrate Dehydrogenase; C543588:IDH1 protein, human