Time from diagnosis to treatment has no impact on survival in newly diagnosed acute myeloid leukemia treated with venetoclax-based regimens
David Baden, Sven Zukunft, Gema Hernandez, Nadine Wolgast, Sophie Steinhäuser, Alexander Pohlmann, Christoph Schliemann, Jan‐Henrik Mikesch, Björn Steffen, Tim Sauer, Maher Hanoun, Kerstin Schäfer‐Eckart, Stefan W. Krause, Mathias Hänel, Hermann Einsele, Edgar Jost, Tim H. Brümmendorf, Sebastian Scholl, Andreas Hochhaus, Andreas Neubauer, Andreas Burchert, Martin Kaufmann, Dirk Niemann, Markus Schaich, Wolfgang Blau, Alexander Kiani, Martin Görner, Ulrich Kaiser, Johannes Kullmer, Thomas Weber, Wolfgang E. Berdel, Gerhard Ehninger, Carsten Müller‐Tidow, Uwe Platzbecker, Hubert Serve, Martin Bornhäuser, Christoph Röllig, Claudia D. Baldus, Lars Fransecky
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.