The Fellow on Call: The Heme/Onc Podcast
Episode 125: AML Series, Pt 11 - Treatment of patients unfit for intensive therapy
Dec 18, 2024
Explore innovative treatment strategies for elderly patients with acute myeloid leukemia who can't handle intensive therapy. Learn about assessing fitness for treatment and the significance of genetic mutations. Discover how modern therapies like azacitidine and venetoclax are reshaping care for frail patients. Key clinical trials, including Viali-A and LACEWING, reveal improved outcomes. The episode delivers valuable insights into navigating the complexities of AML management in older, less fit patients.
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Quick takeaways
- Assessing patient fitness for intensive AML therapy relies on comprehensive evaluations, highlighting the challenges of current assessment tools and their limitations.
- Recent advancements in AML treatment, including hypomethylating agents and venetoclax, offer improved survival rates for older patients unfit for intensive chemotherapy.
Deep dives
Understanding Patient Fitness for Treatment
Defining which patients are fit for intensive chemotherapy is crucial in managing elderly patients with acute myeloid leukemia (AML). Fitness assessments often rely on clinical judgment and holistic evaluations, encompassing various tools such as ECOG and Karnofsky performance status. However, these measures can be misleading due to their broad nature and lack of specificity regarding comorbid conditions. The challenge lies in determining which patients may be better served by supportive care rather than intensive therapies, emphasizing the need for further research into geriatric assessments and treatments tailored for frail patients.
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