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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  FLT3 ITD,  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.

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