Geriatric assessment in older adults with acute myeloid leukemia: A Young International Society of Geriatric Oncology narrative review.

The therapeutic landscape of acute myeloid leukemia (AML) in older adults has been transformed by the advent of targeted therapies, including venetoclax (a B-cell lymphoma-2 inhibitor), gilteritinib (a FMS-like tyrosine kinase 3 inhibitor), ivosidenib, and enasidenib (isocitrate dehydrogenase 1/2 inhibitors). These agents, in combination with hypomethylating agents, have significantly improved outcomes among patients aged 60 years and older, however, overall survival remains very poor. Hence, the management of AML in this population requires a nuanced approach to balance overall survival, treatment-related toxicities, quality of life, and the preservation of functional independence. In recent years, geriatric assessment (GA) has emerged as a critical strategy to identify vulnerabilities that may not be captured in routine oncology evaluations. This assessment helps guide tailored interventions to optimize the fitness of older adults, allowing for better risk stratification and thereby informing treatment plans. This review discusses available evidence for each domain within the GA, feasibility of GA in clinical trials, and gaps in knowledge and future directions to fill those gaps.