Background <p>Few Chinese study compared the impacts of idarubicin and daunorubicin based “3+7” intensive chemotherapies on early and long-term outcomes of AML patients through exploring their real-world data.</p> Patients and methods <p>Our none promyelocytic AML patients inducted with “3+7” regimens were studied to find out the factors relating with induction response and long term survival.</p> Results <p>Idarubicin induction was related with less chemotherapy refractory rate comparing with daunorubicin induction (10% vs 25%, <i>P</i> = 0.02). But cytogenetic molecular risk classification was the only independent factor relating with achieving CR after initial induction or chemotherapy refractory (<i>P</i> = 0.000 and 0.036). Both to overall survival (OS) and progress free survival (PFS), having transplantation and chemotherapy refractory were independent factors related, MLL rearrangement and DNA methylating related genes’ mutations as well. CR at time of transplantation and MLL rearrangement were independent factors relating both with OS after transplantation and relapse free survival after transplantation.</p> Conclusion <p>Traditional “3+7” chemotherapy regimen with idarubicin plays better in CR induction than that with daunorubicin. But the patient’s long-term survival related with clinical practice aspects, like having stem cell transplantation, as well as genetic alterations equally, like MLL rearrangement and DNA methylating related genes’ mutations.</p>