{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:53:34Z","timestamp":1790657614154,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T00:00:00Z","timestamp":1680220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In older patients with acute myeloid leukemia (AML), the definition of fitness, prognosis, and risk of death represents an open question.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In the present study, we tested the impact on survival of disease\u2010 and patient\u2010related parameters in a large cohort of elderly AML patients homogeneously assigned to treatment with hypomethylating agents (HMAs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 131 patients with a median age of 76\u2009years, we confirmed that early response (&lt;0.001) and biology\u2010based risk classification (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.003) can select patients with better\u2010predicted survival. However, a full disease\u2010oriented model had limitations in stratifying our patients, prompting us to investigate the impact of baseline comorbidities on overall survival basing on a comorbidity score. The albumin level (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.001) and the presence of lung disease (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.013) had a single\u2010variable impact on prognosis. The baseline comorbidity burden was a powerful predictor of patients' frailty, correlating with increased incidence of adverse events, especially infections, and predicted overall survival (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The comorbidity burden may contribute to impact prognosis in addition to disease biology. While the therapeutic armamentarium of elderly AML is improving, a comprehensive approach that combines AML biology with tailored interventions to patients' frailty is likely to fully exploit the anti\u2010leukemia potential of novel drugs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.5858","type":"journal-article","created":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T12:55:04Z","timestamp":1680267304000},"page":"11838-11848","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The baseline comorbidity burden affects survival in elderly patients with acute myeloid leukemia receiving hypomethylating agents: Results from a multicentric clinical study"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6309-0515","authenticated-orcid":false,"given":"Giovanni","family":"Marconi","sequence":"first","affiliation":[{"name":"IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura 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