Finding the right fit: assessment of fitness in AML

In this issue of Blood Advances, Venditti et al 1 detail a set of recommendations from the European Leukemia Network (ELN) on fitness assessment in acute myeloid leukemia (AML).Based on the Grading of Recommendations Assessment, Development, and Evaluation methodology, statements 2 were assigned an evidence level and grade, followed by a 2-round Delphi consensus process on the level of agreement involving 31 hematologists with disease-specific expertise and patient representatives.In the last decade, both the complexity of AML treatment and potential considerations for fitness assessments have grown, with a lack of consensus on the required components.The development of both targeted and nonintensive therapies has shifted the thinking of treatment eligibility from a binary "fit" or "unfit" for intensive chemotherapy (IC) to a position where many patients may be eligible for at least lower-intensity treatment.These ELN guidelines therefore provide a critical tool to help define fitness/unfitness and support efforts to identify and categorize individual factors that contribute to these definitions.