Version 1
: Received: 27 September 2024 / Approved: 29 September 2024 / Online: 30 September 2024 (09:19:50 CEST)
How to cite:
Molica, M.; Canichella, M.; Jabbour, E.; Ferrara, F. Evaluating Fitness in Older Acute Myeloid Leukemia Patients: Balancing Therapy and Treatment Risks. Preprints2024, 2024092322. https://doi.org/10.20944/preprints202409.2322.v1
Molica, M.; Canichella, M.; Jabbour, E.; Ferrara, F. Evaluating Fitness in Older Acute Myeloid Leukemia Patients: Balancing Therapy and Treatment Risks. Preprints 2024, 2024092322. https://doi.org/10.20944/preprints202409.2322.v1
Molica, M.; Canichella, M.; Jabbour, E.; Ferrara, F. Evaluating Fitness in Older Acute Myeloid Leukemia Patients: Balancing Therapy and Treatment Risks. Preprints2024, 2024092322. https://doi.org/10.20944/preprints202409.2322.v1
APA Style
Molica, M., Canichella, M., Jabbour, E., & Ferrara, F. (2024). Evaluating Fitness in Older Acute Myeloid Leukemia Patients: Balancing Therapy and Treatment Risks. Preprints. https://doi.org/10.20944/preprints202409.2322.v1
Chicago/Turabian Style
Molica, M., Elias Jabbour and Felicetto Ferrara. 2024 "Evaluating Fitness in Older Acute Myeloid Leukemia Patients: Balancing Therapy and Treatment Risks" Preprints. https://doi.org/10.20944/preprints202409.2322.v1
Abstract
Assessing the suitability of older adults with acute myeloid leukemia (AML) to intensive chemotherapy or stem cell transplantation remains a long-standing challenge. Geriatric assessment, which evaluates multiple dimensions of health, may influence a patient's ability to tolerate intensive or mild intensity approach, including treatment related mortality. Prospective studies are needed to validate different fitness criteria as well as to compare the effectiveness of geriatric assessment–based fitness against other criteria, in order to identify which aspects of the geriatric assessment are linked to treatment tolerance. Hopefully, validation studies should include different group of patients receiving either intensive or lower-intensity chemotherapy. At a minimum, the geriatric assessment should measure 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 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, quality of life, and treatment adjustments or discontinuation due to toxicities. Validating these fitness criteria is essential for guiding treatment choices, improving supportive care, determining trial eligibility, interpreting study outcomes, and informing drug labeling.
Keywords
fitness, acute myeloid leukemia, dynamic fitness
Subject
Medicine and Pharmacology, Hematology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
