Photo Credit: Nemes Laszlo

The following is a summary of “A Phase II Trial of Geriatric Assessment-Guided Selection of Treatment Intensity in Older Adults With AML,” published in the April 2025 issue of American Journal of Hematology by Bhatt et al. 

Researchers conducted a retrospective study to assess the use of geriatric assessment in determining chemotherapy intensity for older adults (OAs) aged 60 years and above with acute myeloid leukemia (AML).  

They applied geriatric assessment and genetic testing to individualize chemotherapy intensity, aiming to reduce early mortality (NCT03226418). The study used broad eligibility criteria to reflect real-world populations. Of the enrolled participants, 45% were aged 70 years or older, 57% had 2 or more comorbidities, and 27% reported a history of solid tumors. Impairments in at least 2 geriatric assessment domains were observed in 74% of individuals, guiding treatment decisions. Additionally, 32% lived in rural settings, and 45% received shared care with community oncologists. The median time from enrollment to treatment initiation was 1 day (range 0–13).  

The results showed that 8 individuals (11%) received intensive chemotherapy, while the remaining participants were treated with low-intensity chemotherapy. The mortality rate at 30 days from diagnosis was 6.8% (95% confidence interval [CI] 3.0%–15.1%), and by 90 days, the mortality rate had increased to 21.9% (95% CI 14.0%–32.7%). The 1-year overall survival rate was reported as 45.9% (95% CI 35.6%–59.3%).  

Investigators concluded that pre-treatment geriatric assessment in OAs with AML was feasible, identified functional impairments, and could guide treatment intensity selection, although a randomized trial was necessary to confirm its survival benefit over traditional approaches. 

Source: onlinelibrary.wiley.com/doi/10.1002/ajh.27694