Impact of Chemotherapy Delay on Overall Survival for AML with IDH1/2 Mutations: A Study in Adult Chinese Patients

• Published in: PloS one Vol. 10; no. 10; p. e0140622
• Main Authors: Wang, Jing-Han, Guo, Qi, Ma, Zhi-Xin, Ma, Qiu-Ling, Yu, Meng-Xia, Yin, Xiu-Feng, Lu, Sha-Sha, Xie, Hong-Qiong, Jiang, Yue-Hong, Shen, Dan, Ma, Li-Ya, Shi, Hui, Yu, Wen-Juan, Lou, Ye-Jiang, Li, Ying, Yang, Min, Xu, Gai-Xiang, Mao, Li-Ping, Li, Jian-Hu, Wang, Huan-Ping, Wang, Dong-Mei, Wei, Ju-Ying, Tong, Hong-Yan, Huang, Jian, Jin, Jie
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 14-10-2015; Public Library of Science (PLoS)
• Subjects: Acute myelocytic leukemia; Acute myeloid leukemia; Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Asian Continental Ancestry Group; Chemotherapy; China; Delay; Diagnosis; DNA nucleotidylexotransferase; Drug therapy; Female; Gene mutation; Genetic aspects; Health aspects; Hematology; Humans; Isocitrate Dehydrogenase - genetics; Laboratories; Leukemia; Leukemia, Myeloid, Acute - diagnosis; Leukemia, Myeloid, Acute - drug therapy; Leukemia, Myeloid, Acute - genetics; Leukemia, Myeloid, Acute - mortality; Male; Medical prognosis; Middle Aged; Mutation; Myeloid leukemia; Niche marketing; Patients; Prognosis; Shape effects; Survival; Time Factors; Young Adult; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0140622

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.