Incorporating Function and Cognition Into Mortality Risk Assessment for Acute Myeloid Leukemia

To the Editor We applaud Sorror and colleagues for systematically investigating the association of comorbidities with the risks of mortality in patients with acute myeloid leukemia (AML). As the authors pointed out, more than half of new AML cases are diagnosed in adults aged 60 years and older. The optimal treatment for this vulnerable group is unclear, and practice patterns vary in this population. Comorbid conditions are prevalent in older adults with AML, and prior studies have reported that between 36% and 45% of older patients have significant comorbidities (Hematopoietic Cell Transplantation–Comorbidity Index score of >1). Although the proposed AML composite model is not specific to older adults, it has the potential to help guide oncologists in selecting treatment for this population. Given the evidence supporting the feasibility and utility of comorbidity assessment in AML, a next logical step is to integrate comorbidity screening routinely into multisite AML trials. The burden is low and potential yield is high.

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