Background: Acute myeloid leukemia (AML) necessitates timely treatment, yet the impact of prolonged time to treatment (TTT) on clinical outcomes remains debated, especially its impact on achieving measurable residual disease (MRD) negativity, a powerful prognostic indicator in AML. Methods: This retrospective study analyzed 196 adult AML patients treated with intensive chemotherapy, evaluating the effect of TTT on outcome measures and quality of response. TTT was categorized arbitrarily into <8, 8–14, and >14 days. Results: Results showed a median TTT of 11 days. Median overall survival (OS) was 414 days, with no significant differences among TTT groups (p= 0.48). Complete remission rate was 75.5%, with significantly higher rates in patients treated within 14 days (p= 0.004 andp= 0.006 for 8–14 and <8 days, respectively) compared to >14 days. MRD was assessed in 140 patients, with 35% achieving negativity, and no significant differences observed among TTT groups. Conclusions: This study suggests that a treatment delay of up to 14 days does not negatively impact OS or MRD negativity. This timeframe potentially allows for thorough patient evaluation, including detailed genetic profiling and comorbidity assessment, facilitating a more personalized and optimized therapeutic strategy.
背景：急性髓系白血病（AML）需要及时治疗，但治疗等待时间（TTT）对临床结局的影响仍存在争议，尤其是其对实现可测量残留病（MRD）阴性这一AML重要预后指标的影响。方法：本回顾性研究分析了196例接受强化化疗的成人AML患者，评估了TTT对治疗结局指标及缓解质量的影响。TTT被任意分为<8天、8–14天和>14天三组。结果：结果显示中位TTT为11天。中位总生存期（OS）为414天，各TTT组间无显著差异（p=0.48）。完全缓解率为75.5%，其中在14天内接受治疗的患者（8–14天组和<8天组，p值分别为0.004和0.006）缓解率显著高于>14天组。对140例患者进行了MRD评估，35%达到阴性，各TTT组间未见显著差异。结论：本研究表明，长达14天的治疗延迟不会对OS或MRD阴性率产生负面影响。这一时间窗口可能为全面评估患者病情（包括详细遗传学分析和合并症评估）提供了条件，有助于制定更个体化、更优化的治疗策略。
肿瘤(癌症)患者之家