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Definition of Unfit for Standard Acute Myeloid Leukemia Therapy

  • Acute Myeloid Leukemias (H Erba, Section Editor)
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Abstract

Determining who is fit or unfit for standard treatments among older adults with acute myeloid leukemia (AML) remains a challenge. However, available evidence can provide guidance on strategies to assess and categorize fitness. Evidence is strongest to guide identification of “frail” older adults at the time of diagnosis based on performance status, physical function, and comorbidity. Many older adults, with adequate performance status and comorbidity burden, however, may be better characterized as “vulnerable”. These patients have subclinical impairments that limit resilience when stressed with intensive therapies. More sensitive assessment strategies are needed to differentiate fit and vulnerable older adults regardless of chronologic age. Research is ongoing to identify tools and approaches, such as geriatric assessment, that can enhance characterization of fitness for AML therapies. This review will highlight available evidence for assessment of fitness among older adults with AML and discuss implications for practice and research.

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  1. Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA

    Heidi D. Klepin

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Heidi Klepin is a consultant for Celgene and contributor for Uptodate.

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This article is part of the Topical Collection on Acute Myeloid Leukemias

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Klepin, H.D. Definition of Unfit for Standard Acute Myeloid Leukemia Therapy. Curr Hematol Malig Rep 11, 537–544 (2016). https://doi.org/10.1007/s11899-016-0348-8

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