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We evaluated the non-inferiority of HMA monotherapy compared to HMA\/VEN combination in 227 AML patients aged\u2009\u2265\u200975\u00a0years receiving HMA or HMA\/VEN combination. No difference in overall survival (OS) was observed between the two groups, with HMA monotherapy demonstrating statistical non-inferiority. HMA-treated patients with favorable performance status had longer OS. The HMA\/VEN group experienced higher mortality and worse QoL. 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