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New treatment opportunities for older patients with acute myeloid leukemia and the increasing importance of frailty assessment - An oncogeriatric perspective.
Diekmann, Benno; Timmerman, Marjolijn; Hempenius, Liesbeth; van Roon, Eric; Franken, Bas; Hoogendoorn, Mels.
Affiliation
  • Diekmann B; Department of Internal Medicine, Medical Centre Leeuwarden, Henri Dunantweg 2, Leeuwarden, the Netherlands; Department of Clinical Pharmacy & Pharmacology, Medical Centre Leeuwarden, Henry Dunantweg 2, Leeuwarden, the Netherlands; Unit of Pharmacotherapy, Epidemiology and Economics, Department o
  • Timmerman M; Department of Internal Medicine, Medical Centre Leeuwarden, Henri Dunantweg 2, Leeuwarden, the Netherlands; Department of Geriatric Care, Medical Centre Leeuwarden, Henry Dunantweg 2, Leeuwarden, the Netherlands.
  • Hempenius L; Department of Geriatric Care, Medical Centre Leeuwarden, Henry Dunantweg 2, Leeuwarden, the Netherlands.
  • van Roon E; Department of Clinical Pharmacy & Pharmacology, Medical Centre Leeuwarden, Henry Dunantweg 2, Leeuwarden, the Netherlands; Unit of Pharmacotherapy, Epidemiology and Economics, Department of Pharmacy, University of Groningen, Antonius Deusinglaan 1, Groningen, the Netherlands; MCL Academy, Medica
  • Franken B; Department of Internal Medicine, Medical Centre Leeuwarden, Henri Dunantweg 2, Leeuwarden, the Netherlands.
  • Hoogendoorn M; Department of Internal Medicine, Medical Centre Leeuwarden, Henri Dunantweg 2, Leeuwarden, the Netherlands.
J Geriatr Oncol ; 15(2): 101631, 2024 Mar.
Article in En | MEDLINE | ID: mdl-37783588
With the introduction of targeted chemotherapy drugs, a new age of treatment for acute myeloid leukemia (AML) has begun. The promotion of the azacitidine+venetoclax combination regimen to first line of treatment in patients deemed ineligible for intensive chemotherapy marks the first of many novel combination regimens becoming part of national treatment guidelines. We review recent phase II and III clinical trials and conclude that these novel regimens offer significant increases in response rates, remission rates, and overall survival. The incidence of adverse events, the accrued time toxicity, and the healthcare costs, however, are increasing as well. Compared with clinical trials, older patients in the real world frequently present with an inferior baseline health status, which is associated with an increased risk of experiencing side effects. The key to reaping the maximum benefit of the new agents and their combination regimens therefore lies in sufficient attention being given to a patients' preexisting comorbidities, potential frailty, and quality of life. A systematic collaboration between hemato-oncologists and geriatricians can be a potent first step towards addressing the increased treatment intensity patients with AML experience under the novel regimens. In this narrative review article we provide an overview of recent and ongoing clinical trials, highlight encountered adverse events, discuss frailty assessment options, and outline an oncogeriatic care path for older patients with AML.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Leukemia, Myeloid, Acute / Frailty Type of study: Guideline Aspects: Patient_preference Limits: Humans Language: En Journal: J Geriatr Oncol Year: 2024 Document type: Article Country of publication: Netherlands

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Leukemia, Myeloid, Acute / Frailty Type of study: Guideline Aspects: Patient_preference Limits: Humans Language: En Journal: J Geriatr Oncol Year: 2024 Document type: Article Country of publication: Netherlands