Acute myeloid leukemia in older adults

Abstract

Acute myeloid leukemia (AML) is a disease of older adults, and approximately 58% are diagnosed in those aged ≥65 years. Outcomes in older adults with AML are poor due to a combination of factors including disease biology, under-referral, undertreatment, and poor treatment tolerability. For selected older patients with AML, treatment is associated with improved survival. The optimal treatment for older patients with AML is unclear. While intensive induction chemotherapy has been used for the last few decades, it has been associated with high treatment-related morbidity and mortality. In the last decade, many advances in the treatment of AML have been made, including the use of targeted agents and novel combinations of lower-intensity treatments, the latter of which may have better tolerability and similar or better efficacy compared to intensive chemotherapy. Nonetheless, to help personalize therapies for older adults with AML, it is important to assess individual fitness through the use of a geriatric assessment. Improving outcomes of older adults with AML will rely on both development of novel therapies and targeting therapy to their physiologic fitness and disease biology.