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Based on randomized trials CPX 351, midostaurin, gemtuzumab ozogamicin, and venetoclax, the latter three when combined with other drugs, should now be considered standard therapy. Knowledge of the likely results with these therapies is essential in deciding whether to recommend them or participate in a clinical trial, possibly including these drugs. Hence here, in the context of established prognostic algorithms, we review results with the recently\u2010 approved drugs compared with their predecessors and describe other potential options. We discuss benefit\/risk ratios underlying the decision to offer allogeneic transplant and emphasize the importance of measurable residual disease. When first seeing a newly\u2010diagnosed patient physicians must decide whether to offer conventional treatment or investigational therapy, the latter preferably in the context of a clinical trial. As noted below, such trials have led to changes in what today is considered \u201cconventional\u201d therapy compared to even 1\u20102\u2009years ago. In older patients decision making has often included inquiring whether specific anti\u2010AML therapy should be offered at all, rather than focusing on a purely palliative approach emphasizing transfusion and antibiotic support, with involvement of a palliative care specialist.<\/jats:p>","DOI":"10.1002\/ajh.25975","type":"journal-article","created":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T02:27:02Z","timestamp":1598322422000},"page":"1368-1398","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":109,"title":["Acute myeloid leukemia: 2021 update on risk\u2010stratification and management"],"prefix":"10.1002","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0987-8077","authenticated-orcid":false,"given":"Elihu H.","family":"Estey","sequence":"first","affiliation":[{"name":"Division of Hematology University of Washington  Seattle Washington"},{"name":"Clinical Research Division Fred Hutchinson Cancer Research Center  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,17]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40258-013-0032-2"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-015-2351-x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2012.066100"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-12-379008"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-07-172007"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-01-621664"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.38.9429"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-07-627323"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2013.176"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019001728"},{"key":"e_1_2_8_12_1","unstructured":"JakobsenLH RougAS \u00d8vlisenAK et al.Temporal development of survival in adult AML patients in the period 2000\u20132016: a Danish population\u2010based study.2020. 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