Impact of Time to Treatment Initiation on Quality of Response in Patients with Acute Myeloid Leukemia Receiving Intensive Chemotherapy

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 and p = 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.