Treating older patients with AML.

The treatment of older patients with acute myeloid leukemia is a difficult challenge. Older adults are more likely to have comorbidities that can limit treatment options, the disease tends to be more aggressive biologically and outcomes are worse than those in younger patients. Deciding which older patients would benefit from intensive chemotherapy is difficult, and efforts are underway to improve existing risk-assessment tools. Treatment should be individualized and may include standard chemotherapy for those patients who have none or at most one adverse factor, or investigational agents for those presenting with multiple poor-risk features. Low-intensity therapies are recommended for those patients who are deemed too frail to tolerate myelosuppressive regimens.