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Clinical Aspects in the Treatment of Elderly Patients with Acute Myeloid Leukemia

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Hematology".

Deadline for manuscript submissions: closed (20 September 2024) | Viewed by 1760

Special Issue Editor


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Guest Editor
Department of Hematology-Oncology, Azienda Ospedaliera Pugliese-Ciaccio, 88100 Catanzaro, Italy
Interests: hematologic diseases; chronic myeloid leukemia (CML); blood disorders; clinical hematology; myelodysplastic syndromes; haematological studies; acute myeloid leukemia

Special Issue Information

Dear Colleagues,

In recent years, the development of new therapies for acute myeloid leukemia (AML) has progressed slowly. For decades, the standard treatment for AML has been intensive induction chemotherapy, sometimes followed by a hematopoietic stem cell transplant. Unfortunately, older patients are less responsive to such aggressive chemotherapy and cannot tolerate it. Since the majority of AML patients are elderly, this group has been most affected by the lack of newer, less-toxic therapies. However, the landscape of AML treatments given to elderly patients has recently changed significantly with the approval of several new drugs.

The aim of this Special Issue is to update the current knowledge on the treatment of elderly patients with AML who are unfit for intensive chemotherapy. We encourage you to submit your scientific article in order to improve our shared knowledge of this topic and implement new approaches in clinical practice.

Dr. Matteo Molica
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • acute myeloid leukemia
  • unfit patients
  • non-chemotherapy approaches
  • treatment stratification by fitness
  • target therapies

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Published Papers (1 paper)

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Review

12 pages, 1269 KiB  
Review
Evaluating Fitness in Older Acute Myeloid Leukemia Patients: Balancing Therapy and Treatment Risks
by Matteo Molica, Martina Canichella, Elias Jabbour and Felicetto Ferrara
J. Clin. Med. 2024, 13(21), 6399; https://doi.org/10.3390/jcm13216399 - 25 Oct 2024
Viewed by 1506
Abstract
Assessing the suitability of older adults with acute myeloid leukemia (AML) for intensive chemotherapy or stem cell transplantation remains a long-standing challenge. Geriatric assessment, which involves the evaluation of multiple dimensions of health, may influence a patient’s ability to tolerate intensive or mild-intensity [...] Read more.
Assessing the suitability of older adults with acute myeloid leukemia (AML) for intensive chemotherapy or stem cell transplantation remains a long-standing challenge. Geriatric assessment, which involves the evaluation of multiple dimensions of health, may influence a patient’s ability to tolerate intensive or mild-intensity approaches, including treatment-related mortality. Prospective studies are required to validate different fitness criteria, in addition to making it possible to compare the effectiveness of geriatric assessment-based fitness against other criteria, in order to identify which aspects of geriatric assessment are linked to treatment tolerance. It is hoped that validation studies will include different groups of patients receiving either intensive or lower-intensity chemotherapy. At a minimum, geriatric assessment should involve the measurement of the comorbidity burden, cognition, physical function, and emotional health—factors previously associated with mortality in AML. These assessments should be conducted before starting chemotherapy in order to minimize the treatment’s impact on the results. While treatment tolerance has traditionally been evaluated through toxicity rates in solid tumor patients, AML treatment often results in high toxicity rates regardless of the intensity. Therefore, early mortality should be the primary endpoint for assessing treatment tolerance, given its significant and clear implications. Other important endpoints might include declines in functional status and quality of life and treatment adjustments or discontinuation due to toxicity. Validating these fitness criteria is essential for guiding treatment choices, improving supportive care, determining trial eligibility, interpreting study outcomes, and informing drug labeling. Full article
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