Frailty and geriatric assessments in older patients diagnosed with acute myeloid leukaemia: an Australasian Leukaemia and Lymphoma Group consensus statement

The treatment of acute myeloid leukaemia (AML) is rapidly changing, and treatment decisions are more complex, with increasing therapeutic options available for those 'unfit' for intensive cytotoxic therapy. With the median age of 69 years at diagnosis, frailty is expected to be highly prevalent in patients with AML. An individualised approach is required, accounting for disease biology, chronological age, functional status, social factors, patient-directed goals of care and co-morbidities. This Australasian Leukaemia and Lymphoma Group (ALLG) consensus statement aims to highlight the importance of performing geriatric and frailty assessments (FAs) in older patients diagnosed with AML and provide practical recommendations on integrating FAs into routine clinical practice within the Australian and New Zealand context. We recommend FAs be widely implemented and tailored to the resources of individual centres to provide an objective measure of fitness of older patients with AML to assist therapeutic decisions at diagnosis as well as at serial timepoints throughout the disease course. Deficits in domains identified by FAs can specifically be targeted through supportive care interventions aiming to improve tolerance of therapy. FAs should be incorporated into clinical trials and be prioritised for funding and resources.