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AML patient frail or elderly unfit for intensive induction: age ≥75, OR age ≥65 with ≥2 c...

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IDRF-AML-FRAILTY-AGE
TypeSignal d’alerte
Étatreviewed 2026-04-25 | pending_clinical_signoff
MaladiesDIS-AML
SourcesSRC-ELN-AML-2022 SRC-NCCN-AML-2025 SRC-VIALE-A-DINARDO-2020

Origine du drapeau rouge

DéfinitionAML patient frail or elderly unfit for intensive induction: age ≥75, OR age ≥65 with ≥2 comorbidities (HCT-CI ≥3), OR ECOG ≥2 with multiple comorbidities, OR explicit clinical assessment 'unfit for intensive chemotherapy'
Direction cliniquedésescalade
Catégorieâge de fragilité
Algorithme de décalageALGO-AML-1L

Logique de déclenchement

{
  "any_of": [
    {
      "comparator": ">=",
      "finding": "age_years",
      "threshold": 75
    },
    {
      "finding": "fit_for_intensive_chemo",
      "value": false
    },
    {
      "comparator": ">=",
      "finding": "hct_ci_score",
      "threshold": 3
    },
    {
      "finding": "aml_frail_unfit",
      "value": true
    }
  ],
  "type": "composite"
}

Notes

Triggers de-escalation from 7+3 + (midostaurin) to ven+aza (VIALE-A; OS 14.7 vs 9.6 mo for unfit AML). Age alone is not the decision — comorbidity (HCT-CI / Sorror) + functional status drive the choice. AlloHCT also generally off the table for this group. STUB — requires clinical co-lead signoff.

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Indication