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In a phase II trial of older adults \u2265\u200960\u2009years with AML (<jats:italic>n<\/jats:italic>\u2009=\u200973), we used geriatric assessment (measures of comorbidity burden, physical and cognitive function) to determine fitness for intensive chemotherapy. We integrated the geriatric assessment and genetic test results to personalize the selection of chemotherapy intensity with a goal to reduce early mortality (NCT03226418). Broad eligibility criteria allowed enrolling patients representative of those treated in real\u2010world practices: 45% of patients were \u2265\u200970\u2009years, 57% had \u2265\u20092 comorbidities, 27% had a history of solid malignancies, and 74% had impairments in \u2265\u20092 geriatric assessment domains used to assign treatment intensity. Thirty\u2010two percent of patients resided in rural areas, and 45% were comanaged with community oncologists. The median time from enrollment to therapy initiation was 1\u2009day (range 0\u201313). Eight patients (11%) received intensive chemotherapy; others received low\u2010intensity chemotherapy. Mortality at 30\u2009days from diagnosis was 6.8% (95% confidence interval, CI 3.0%\u201315.1%) and at 90\u2009days was 21.9% (95% CI 14.0%\u201332.7%). One\u2010year survival was 45.9% (95% CI 35.6%\u201359.3%). Our study demonstrates that pre\u2010treatment geriatric assessment in older adults with AML is feasible, can identify several functional impairments, and guide the selection of treatment intensity. A randomized trial is necessary to confirm the survival benefit of this approach over the traditional approach of treatment selection.<\/jats:p><jats:p>\n<jats:bold>Trial Registration:<\/jats:bold> NCT03226418<\/jats:p>","DOI":"10.1002\/ajh.27694","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T08:49:22Z","timestamp":1745916562000},"page":"1163-1172","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["A Phase <scp>II<\/scp> Trial of Geriatric Assessment\u2010Guided Selection of\u00a0Treatment Intensity in Older Adults With <scp>AML<\/scp>"],"prefix":"10.1002","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2513-0533","authenticated-orcid":false,"given":"Vijaya R.","family":"Bhatt","sequence":"first","affiliation":[{"name":"Division of Hematology\u2010Oncology, Department of Internal Medicine University of Nebraska Medical Center  Omaha Nebraska 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