title: Advances in the treatment of elderly and frail patients with acute myeloid leukemia.
abstract: OBJECTIVE
  Significant advances have been made in the treatment of younger patients with acute myeloid leukemia over the past 3 decades, but prognosis in the elderly has remained dismal, with median survival times of only a few months. Although a small percentage of older patients may be cured by standard chemotherapy, it is clear that several aspects of frontline management require improvement and novel approaches are urgently needed. This review focuses on treatment options currently available to older patients with acute myeloid leukemia, with an emphasis on new therapeutics.
  
  
  RESULTS
  Developing risk-assessment tools is critical to identify older patients who are most likely to benefit from intensive chemotherapy, but optimal induction and postremission therapies have yet to be determined in this population. New strategies and treatments are emerging and under current assessment. In particular, investigations of monoclonal antibodies, hypomethylating agents, signal transduction inhibitors, and novel cytotoxics hold promise for improving outcomes in older patients with acute myeloid leukemia, including those for whom traditional chemotherapy is not considered appropriate.
  
  
  CONCLUSIONS
  Acute myeloid leukemia remains a therapeutic challenge in elderly patients, but, following a period of paucity in discoveries, several new treatments are finally emerging that may offer future improvement for these patients.
authors.affiliation: Department of Hematology, Tor Vergata University Hospital, Rome, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Amadori
authors.forename: Maria Ilaria
authors.initials: MI
authors.lastname: Del Principe
authors.forename: Adriano
authors.initials: A
authors.lastname: Venditti
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D016330:Frail Elderly; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents