Association of sarcopenia with treatment tolerance in older adults with acute myeloid leukemia using artificial intelligence computed tomography–segmentation and a geriatric assessment

Less intensive treatment (LIT) regimens, primarily the combination of a hypomethylating agent and venetoclax (HMA+venetoclax), have replaced intensive regimens for the frontline treatment of AML for most older adults [ 1 ]. However, poor treatment tolerance remains an issue for older adults receiving LIT. Older adults receiving HMA+venetoclax continue to experience high 60- and 90-day mortality (10–20%), with frequent dose reductions and treatment discontinuations [ 2 ]. Patients value preservation of physical function as a measure of treatment tolerance [ 3 ]. Impaired physical function also predicts poor treatment tolerance and shorter survival in older adults receiving intensive and LIT regimens [ 4 ]. Evidence-based strategies to improve treatment tolerance represent a care gap in the management of older adults with AML.