title: How I treat the older patient with acute myeloid leukemia.
abstract: Acute myeloid leukemia (AML) in older patients presents a notable therapeutic challenge to the clinical hematologist. The clinical biology of AML among patients is highly heterogeneous. Interpatient variations are relevant for prognosis and treatment choice. Outcome of treatment for patients of advanced age is often compromised by comorbid conditions and an enhanced susceptibility to toxicities from therapy. Here we present selected clinical vignettes that highlight distinct representative situations derived from clinical practice. The vignettes are specifically discussed in light of the perspective of treating older patients with leukemia. We review the clinical significance of various cytogenetic and molecular features of the disease, and we examine the various currently available treatment options as well as the emerging prognostic algorithms that may offer guidance in regard to personalized therapy recommendations. The dilemmas in tailoring treatment selection in this category of patients with AML are the central theme in this discussion.
authors.affiliation: Department of Hematology, VU University Medical Center, Amsterdam and Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Gert
authors.initials: G
authors.lastname: Ossenkoppele
authors.affiliation: Department of Hematology, VU University Medical Center, Amsterdam and Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Bob
authors.initials: B
authors.lastname: Löwenberg
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols; D001374:Azacitidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D002986:Clinical Trials as Topic; D020732:Cytogenetic Analysis; D000077209:Decitabine; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000235:genetics / Q000401:mortality / Q000628:therapy*; D008297:Male; D058990:Molecular Targeted Therapy; D057285:Precision Medicine / Q000379:methods*; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000077209:Decitabine; D001374:Azacitidine