Published February 6, 2025 | Version v1
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FITNESS ASSESSMENT IN ACUTE MYELOID LEUKEMIA: RECOMMENDATIONS FROM AN EXPERT PANEL ON BEHALF OF EUROPEAN LEUKEMIA NET.

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Fitness assessment in patients with acute myeloid leukemia (AML) is critical to deliver the right therapy to the right patient. While several scoring systems are available to aid in determining fitness, the absence of validation studies has resulted in the lack of universally accepted assessment procedures. This limitation, combined with the increasing availability of novel agents expanding the spectrum of less-intensive options, has introduced additional complexity to the fitness assessment process. In this evolving context, fitness should reflect eligibility for a specific treatment among the several available, rather than a generic binary classification of eligibility for intensive chemotherapy. Moreover, the growing emphasis on patient-centered care, further highlights the importance of integrating quality of life, patients' preferences, patients' self-reported physical and social functioning status, social support, and early integration of palliative care into the assessment framework. A modern interpretation of fitness assessment should incorporate a comprehensive evaluation that extends beyond traditional clinical and biological disease characteristics. Thus, fitness assessment in patients with AML represents only one piece of a larger puzzle, encompassing the patient's overall capacity to sustain and benefit from a specific therapeutic program. © 2025 American Society of Hematology. Published by Elsevier Inc. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.

Notes

and Pfizer (all are not related to this manuscript) . M.H. reports research funding to institutions from AbbVie, Servier, Astellas, BerGenBio, Glycostem, Jazz Pharmaceuticals, Karyopharm, Loxo Oncology, Novartis, and PinotBio (all are not related to this manuscript) . P. Mehta reports speaker/advisory fees from AbbVie, Astellas, Daiichi Sankyo, Jazz Pharmaceuticals, Menarini, and Pfizer. P. Montesinos reports receiving research support, consultancy fees, speakers bureau fees, and advisory board membership from Agios, Astellas, AbbVie, Pfizer, Daiichi-Sankyo, Tolero Pharmaceuticals, Incyte, Novartis, Forma Therapeutics, GlycoMimetics, Bristol Myers Squibb/Celgene, Janssen, Karyopharm, Sanofi, Servier, Syndax, and Teva (all are not related to this manuscript) . C. Recher reports consulting or advisory role with AbbVie, Amgen, Astellas, Bristol Myers Squibb, Boehringer, Jazz Pharmaceuticals, and Servier; received research funding from AbbVie, Amgen, Astellas, Bristol Myers Squibb, Iqvia, and Jazz Pharmaceuticals; and received support for attending meetings and/or travel from AbbVie, Novartis, and Servier. N.V. received honoraria from AbbVie, Amgen, Bristol Myers Squibb/Celgene, Daiichi, Novartis, and Roche; reports consultancy with Novartis, Janssen, Biokinesis, and Servier; and reports research grants from Bristol Myers Squibb, Jazz, and Innate Pharma. R.B.W. received laboratory research grants and/or clinical trial support from Aptevo, Celgene, ImmunoGen, Janssen, Jazz, Kite, Kura, and Pfizer; has ownership interests in Amphivena; and is (or has been) a consultant to AbbVie, Adicet, Amphivena, BerGenBio, Bristol Myers Squibb, GlaxoSmithKline, ImmunoGen,r Kura, Orum, and Wugen (all are not related to this manuscript) . E.W. reports advisory/consulting role with AbbVie, Bristol Myers Squibb, CTI Biopharma, Blueprint, Immunogen, Kite, Kura, Johnson & Johnson, Qiagen, Rigel, Schrodinger, Daiichi Sankyo, Gilead, GlaxoSmithKline, Stemline, Syndax, Novartis, NuProbe, Rigel, Schrodinger, and Sellas; reports speaking for Pfizer, Astellas, and Dava; and served on the data safety and monitoring committee of AbbVie and Gilead (also research scholar award committee; all are not related to this manuscript) . The remaining authors declare no competing financial interests.

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