[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-448249-105":59,"doc-detail-448249-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","characteristics-of-patients-with-newly-diagnosed-acute-myeloid-leukemia-not-receiving-treatment-letter-to-the-editor","Characteristics of patients with newly diagnosed acute myeloid leukemia not receiving treatment - Letter to the Editor","","Acute myeloid leukemia (AML) varies in biology and outcomes, yet prior reports show many newly diagnosed patients—especially elderly or medically unfit—receive no anti-leukemic therapy. This study retrospectively reviewed 429 AML cases at Mayo Clinic (2016–2023) and identified 40 untreated patients, excluding those lacking cytogenetic/molecular data or prior AML treatment. It describes demographic, cytogenetic, molecular, ELN risk, reasons for deferral, hospice versus best supportive care use, survival patterns, and how treatment deferral changed after venetoclax approval.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/characteristics-of-patients-with-newly-diagnosed-acute-myeloid-leukemia-not-receiving-treatment-letter-to-the-editor/448249/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/characteristics-of-patients-with-newly-diagnosed-acute-myeloid-leukemia-not-receiving-treatment-letter-to-the-editor/448249.png","ImageObject",300,407,{"name":92,"@type":93},"Riley","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-05","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":24},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"How many newly diagnosed AML patients did not receive therapy, and how were they identified?","Question",{"text":112,"@type":113},"Among 429 newly diagnosed AML patients reviewed, 40 (9%) were identified as not receiving therapy after diagnosis. Patients without cytogenetic or molecular data and those previously treated for AML were excluded.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What were the main reasons patients deferred or declined treatment?",{"text":117,"@type":113},"Reasons were grouped into patient preference (72.5%), medical reasons/physician recommendations (25%), and unknown reasons (2.5%). The choice could include both curative and palliative intent.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the most frequent cytogenetic and molecular findings in the untreated group?",{"text":121,"@type":113},"Most patients had abnormal karyotypes (75%), with complex karyotype and specific chromosome abnormalities including monosomy 7 and deletion 7q among the most common. In targeted NGS, TP53, NPM1, and FLT3-ITD were frequently observed mutations.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},448249,1790829558,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":24,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":52},1374391975076,"https://ap-avatar.wpscdn.com/avatar/14000253ca4ec9f6853?x-image-process=image/resize,m_fixed,w_180,h_180&k=1783305029341752051","LETTER TO THE EDITOR  \nCharacteristics of patients with newly diagnosed acute myeloid leukemia not receiving treatment  \nAcute myeloid leukemia (AML) is a heterogeneous malignancy characterized by clonal expansion of myeloid precursor cells. Advances in therapeutic strategies have improved survival in AML, including elderly unfit patients. However, patients who receive intensive therapy spend 30% or more of their life after diagnosis in a hospital compared to patients receiving less-intensive options 1 Other investigators found that AML patients receiving lower-intensity treatment regimens devoted an average of 42% of days following their diagnosis to their oncology care.2 Additionally, [Hubscher.](Hubscher. et)[ et](Hubscher. et)[ ](Hubscher. et)[al](al. reported that an average of 30% of patients in the US do)[. reported that an average of 30% of patients in the US do](al. reported that an average of 30% of patients in the US do)[ ](al. reported that an average of 30% of patients in the US do)[not receive any anti-leukemic treatment after diagnosis.](not receive any anti-leukemic treatment after diagnosis.3)[3](not receive any anti-leukemic treatment after diagnosis.3)[ ](not receive any anti-leukemic treatment after diagnosis.3)[Little to no studies report outcomes of these non-treated](Little to no studies report outcomes of these non-treated)[ ](Little to no studies report outcomes of these non-treated)patients, especially with the relatively recent integration of molecular sequencing. This study evaluates the clinical characteristics, cytogenetic/molecular features, and survival outcomes of untreated AML patients to identify factors that may influence treatment decisions and prognosis.  \nAfter obtaining appropriate institutional review board approval, we retrospectively reviewed the charts of 429 patients newly diagnosed with AML at Mayo Clinic, Rochester, between January 2016 and January 2023, of whom we identified 40 (9%) patients who did not receive therapy following their AML diagnosis. Patients were subcategorized into primary AML, AML following a myeloid neoplasm (myelodysplastic syndrome [MDS], myeloproliferative neoplasm [MPN], MDS/MPN), and myeloid neoplasm post cytotoxic therapy (MN-pCT) .4 Patients with no cytogenetic or molecular data available were excluded from the study. Patients who previously received therapy for AML were also excluded (relapsed or refractory) . The reasons for patients not receiving treatment were categorized into three main groups: (i) patient preference applied to patients who werepresented with the option of treatment, whether curative or palliative, but chose to decline; (ii) medical reasons/ physician recommendations referred to cases where patients’ clinical status and comorbidities excluded them from receiving any form of anti-leukemia treatment; (iii) unknown reasons accounted for patients whose rationale for foregoing treatment was not documented. All data were recorded at the time of diagnostic bone marrow biopsy. Lactate dehydrogenase (LDH) was considered elevated if it was above 222 U/L. We stratified risk using the 2022 European LeukemiaNet (ELN) risk stratification.5 Overall survival (OS) was calculated from the date of AML diagnosis to the date of last follow-up or death. Date of decision refers to the day it was determined that a patient will not receive therapy for AML. For statistical analysis, we used BlueSky Statistics V10.3.4.  \nAmong the untreated group (N=40 [9.3%]), 60% were male. Thirty patients (75%) had an abnormal karyotype, with the most common karyotype abnormalities being complex karyotype (47.5%), monosomy 7 (17.5%), deletion 7q (12.5%), and trisomy 8 (12.5%) . Targeted next-generation sequencing (NGS)6 (Figure 1A) was performed on bone marrow samples from 26 patients, with TP53 being the most frequent mutation (30.8%), followed by NPM1 (25.8%), and FLT3-internal tandem duplication (ITD) (28.1%) ( Online Supplementary Figure S1) . In the cases of NPM1 and","cbCaicfgpSeKdBuP","https://ap.wps.com/l/cbCaicfgpSeKdBuP","pdf",1868535,"English","# Study overview\n## Patient selection and definitions\n## Risk stratification and outcomes\n# Untreated cohort characteristics\n## Demographics and karyotype\n## Molecular profiling and mutations\n## ELN risk distribution\n# Reasons for not receiving treatment\n## Patient preference\n## Medical reasons and unknown reasons\n## Hospice and end-of-life care choices","[{\"question\":\"How many newly diagnosed AML patients did not receive therapy, and how were they identified?\",\"answer\":\"Among 429 newly diagnosed AML patients reviewed, 40 (9%) were identified as not receiving therapy after diagnosis. Patients without cytogenetic or molecular data and those previously treated for AML were excluded.\"},{\"question\":\"What were the main reasons patients deferred or declined treatment?\",\"answer\":\"Reasons were grouped into patient preference (72.5%), medical reasons/physician recommendations (25%), and unknown reasons (2.5%). The choice could include both curative and palliative intent.\"},{\"question\":\"What were the most frequent cytogenetic and molecular findings in the untreated group?\",\"answer\":\"Most patients had abnormal karyotypes (75%), with complex karyotype and specific chromosome abnormalities including monosomy 7 and deletion 7q among the most common. In targeted NGS, TP53, NPM1, and FLT3-ITD were frequently observed mutations.\"}]","Characteristics of patients with newly diagnosed acute myeloid leukemia not receiving treatment - Letter to the Editor | PDF",1790726270]