[Therapy of acute myeloid leukemia (AML) for medically non-fit patients]

Acute myeloid leukemia (AML) has an increasing incidence with higher age, which is about 15 per 100,000 for patients > 65 years. Many older AML patients show functional restrictions and have a high comorbidity status, so that they do not seem to be qualified for a curatively intended chemotherapy. Decisive for the low cure rate of older AML patients are both patient-dependent and disease-dependent reasons such as secondary or therapy-related leukemia or adverse cytogenetics with complex chromosomal abnormalities, which are poor prognostic factors and are responsible for the low probability to achieve long-lasting complete remissions. Prognostic scores are developed for identifying "medically non-fit" patients as objectively as possible. In the future, these patients should not only be offered best supportive care but also well-tolerable concepts of therapy, which are feasible on an ambulatory basis. The main aim for this patient group must be to avoid long hospitalizations and to maintain a high quality of life.