LAUSR

Simple Summary Now that low-intensity therapies, such as DNA methyltransferase inhibitors and venetoclax, have emerged as the leading options for elderly patients, it is increasingly crucial to consider the patient’s age and comorbidities when selecting therapy. In this article, we initially review the factors that influence early mortality and long-term prognosis in patients receiving intensive chemotherapy and the risk categories derived from these factors. Subsequently, we discuss potential treatment options that may overcome these barriers. Abstract Traditionally, the goal of AML therapy has been to induce remission through intensive chemotherapy, maintain long-term remission using consolidation therapy, and achieve higher rates of a cure by allogeneic transplantation in patients with a poor prognosis. However, for the elderly patients and those with comorbidities, the toxicity often surpasses the therapeutic benefits of intensive chemotherapy. Consequently, low-intensity therapies, such as the combination of a hypomethylating agent with venetoclax, have emerged as promising treatment options for elderly patients. Given the rise of low-intensity therapies as the leading treatment option for the elderly, it is increasingly important to consider patients’ age and comorbidities when selecting a treatment option. The recently proposed comorbidity-based risk stratification for AML allows prognosis stratification not only in patients undergoing intensive chemotherapy, but also in those receiving low-intensity chemotherapy. Optimizing treatment intensity based on such risk stratification is anticipated to balance treatment efficacy and safety, and will ultimately improve the life expectancy for patients with AML.