Time from diagnosis to treatment has no impact on survival in newly diagnosed acute myeloid leukemia treated with venetoclax-based regimens

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • David Baden - , University Hospital Schleswig-Holstein Campus Kiel (Author)
  • Sven Zukunft - , Department of Internal Medicine I (Author)
  • Gema Hernandez - , TriNetX Europe NV (Author)
  • Nadine Wolgast - , University Hospital Schleswig-Holstein Campus Kiel (Author)
  • Sophie Steinhauser - , University Hospital Schleswig-Holstein Campus Kiel (Author)
  • Alexander Pohlmann - , University Hospital Münster (Author)
  • Christoph Schliemann - , University Hospital Münster (Author)
  • Jan-Henrik Mikesch - , University Hospital Münster (Author)
  • Bjorn Steffen - , University Hospital Frankfurt (Author)
  • Tim Sauer - , University Hospital Heidelberg (Author)
  • Maher Hanoun - , University Hospital Essen (Author)
  • Kerstin Schafer-Eckart - , Paracelsus Medical University Nuremberg (Author)
  • Stefan W Krause - , University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Mathias Hanel - , Klinikum Chemnitz gGmbH (Author)
  • Hermann Einsele - , TUD Dresden University of Technology (Author)
  • Edgar Jost - , University Hospital Aachen, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) (Author)
  • Tim H Brummendorf - , University Hospital Aachen, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) (Author)
  • Sebastian Scholl - , Jena University Hospital (Author)
  • Andreas Hochhaus - , Jena University Hospital (Author)
  • Andreas Neubauer - , University Hospital Gießen and Marburg (Author)
  • Andreas Burchert - , University Hospital Gießen and Marburg (Author)
  • Martin Kaufmann - , Robert Bosch Krankenhaus Stuttgart (Author)
  • Dirk Niemann - , Gemeinschaftsklinikum Mittelrhein (Author)
  • Markus Schaich - , Rems-Murr-Kliniken (Author)
  • Wolfgang Blau - , Helios HSK Clincs Wiesbaden (Author)
  • Alexander Kiani - , Klinikum Bayreuth GmbH, University Hospital at the Friedrich-Alexander University Erlangen-Nürnberg (Author)
  • Martin Gorner - , Central Hospital Bielefeld (Author)
  • Ulrich Kaiser - , St. Bernward Hospital (Author)
  • Johannes Kullmer - , DIAKO Ev. Diakonie-Krankenhaus gGmbH (Author)
  • Thomas Weber - , Martin Luther University Hospital (Author)
  • Wolfgang E Berdel - , University Hospital Münster (Author)
  • Gerhard Ehninger - , Department of internal Medicine I (Author)
  • Carsten Muller-Tidow - , University Hospital Heidelberg (Author)
  • Uwe Platzbecker - , University Hospital Leipzig (Author)
  • Hubert Serve - , University Hospital Frankfurt (Author)
  • Martin Bornhauser - , Department of Internal Medicine I (Author)
  • Christoph Rollig - , Department of Internal Medicine I (Author)
  • Claudia D Baldus - , University Hospital Schleswig-Holstein Campus Kiel (Author)
  • Lars Fransecky - , University Hospital Schleswig-Holstein Campus Kiel (Author)

Abstract

In newly diagnosed acute myeloid leukemia (AML), immediate initiation of treatment is standard of care. However, deferral of antileukemic therapy may be indicated to assess comorbidities or pretherapeutic risk factors. We explored the impact of time from diagnosis to treatment on outcomes in newly diagnosed AML undergoing venetoclax-based therapy in two distinct cohorts. By querying the Study Alliance Leukemia database and the global health network TriNetX, we identified 138 and 717 patients respectively with an average age of 76 and 72 years who received venetoclax-based first-line therapy. When comparing patients who started treatment earlier or later than 10 days after initial diagnosis, no significant difference in median overall survival was observed - neither in the SAL cohort (7.7 vs. 9.6 months; P=0.42) nor in the TriNetX cohort (7.5 vs. 7.2 months; P=0.41). Similarly, severe infections, bleeding, and thromboembolic events were equally observed between early and later treatments, both in the overall patient groups and specific subgroups (age ≥75 years or leukocytes ≥20x109/L). This retrospective analysis indicates that delaying the start of venetoclax-based therapy in newly diagnosed AML might be a safe option for selected patients, provided that close clinical monitoring is performed.

Details

Original languageEnglish
Pages (from-to)2469-2477
Number of pages9
JournalHaematologica
Volume109
Issue number8
Publication statusPublished - 1 Aug 2024
Peer-reviewedYes

External IDs

PubMedCentral PMC11290507
Scopus 85200423963

Keywords

Keywords

  • Humans, Bridged Bicyclo Compounds, Heterocyclic/therapeutic use, Sulfonamides/therapeutic use, Leukemia, Myeloid, Acute/drug therapy, Aged, Male, Female, Aged, 80 and over, Middle Aged, Time-to-Treatment, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Treatment Outcome, Adult, Retrospective Studies, Antineoplastic Agents/therapeutic use

Library keywords