Acute myeloid leukemia (AML) remains a hematologic emergency, yet molecular profiling may delay induction chemotherapy. We evaluated the association between time to treatment initiation (TTT) and overall survival in 31,617 adults with AML from the National Cancer Database (2016–2020). Mortality risk increased with longer treatment delays, with restricted cubic spline analysis identifying an inflection point at approximately 3–5 days after diagnosis. These findings support efforts to streamline diagnostic workflows and minimize preventable delays in chemotherapy initiation while maintaining precision medicine approaches.

KEYWORDS: Acute Myeloid Leukemia, Time to Treatment, National Cancer Database, Overall Survival, Induction Chemotherapy