Geriatric oncology at a crossroads: Advancing equity and access for elderly leukemia patients in underserved regions

Leukemia predominantly affects the elderly, who face unique clinical challenges related to aging physiology, comorbidities, and social determinants of health. These challenges are further exacerbated in underserved regions where diagnostic and treatment resources are scarce, resulting in delayed diagnoses, limited access to effective therapies, and poorer survival outcomes. This review explores the multifaceted barriers to equitable leukemia care for elderly patients in resource-limited settings, emphasizing the urgent need for targeted interventions. Recent therapeutic advances, including hypomethylating agents, targeted oral therapies, and reduced-intensity conditioning regimens, have improved survival and quality of life for older leukemia patients in high-income settings. However, their availability and implementation in underserved regions remain inadequate due to economic, infrastructural, and policy constraints. We discuss emerging strategies such as decentralizing diagnostics, integrating comprehensive geriatric assessments, leveraging telemedicine, and fostering inclusive clinical trials that can help bridge these gaps. Addressing disparities in geriatric leukemia care demands a coordinated approach involving healthcare providers, policymakers, and community stakeholders. By expanding access to diagnostics and novel therapies, strengthening supportive care, and prioritizing research in diverse populations, the global oncology community can move towards equitable care delivery. Ultimately, ensuring that elderly leukemia patients in underserved regions receive personalized, evidence-based treatment is critical to improving outcomes and honoring their dignity.