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Fitness assessment in acute myeloid leukemia: recommendations from an expert panel on behalf of the European LeukemiaNet
Venditti, A. Palmieri, R. Maurillo, L. Röllig, C. Wierzbowska, A. de Leeuw, D. Efficace, F. Curti, A. Ngai, L. L. Tettero, J.
Venditti, A.
Palmieri, R.
Maurillo, L.
Röllig, C.
Wierzbowska, A.
de Leeuw, D.
Efficace, F.
Curti, A.
Ngai, L. L.
Tettero, J.
Abstract
Fitness assessment in patients with acute myeloid leukemia (AML) is critical to deliver the right therapy to the right patient. Although several scoring systems are available to aid in determining fitness, the absence of validation studies has resulted in the lack of universally accepted assessment procedures. This limitation, combined with the increasing availability of novel agents expanding the spectrum of less-intensive options, has introduced additional complexity to the fitness assessment process. In this evolving context, fitness should reflect eligibility for a specific treatment among the several available, rather than a generic binary classification of eligibility for intensive chemotherapy. Moreover, the growing emphasis on patient-centered care, further highlights the importance of integrating quality of life, patient preferences, patient self-reported physical and social functioning status, social support, and early integration of palliative care into the assessment framework. A modern interpretation of fitness assessment should incorporate a comprehensive evaluation that extends beyond traditional clinical and biological disease characteristics. Thus, fitness assessment in patients with AML represents only 1 piece of a larger puzzle, encompassing the patient's overall capacity to sustain and benefit from a specific therapeutic program.
Authors
Venditti, A.
Palmieri, R.
Maurillo, L.
Röllig, C.
Wierzbowska, A.
de Leeuw, D.
Efficace, F.
Curti, A.
Ngai, L. L.
Tettero, J.
Adès, L.
Almeida, A.
Bullinger, L.
Dennis, M.
Esteve, J.
Ferrara, F.
Heuser, M.
Huls, G.
Lübbert, M.
Mehta, P.
Montesinos, P.
Pabst, T.
Récher, C.
Rossi, G.
Russell, N.
Sierra, J.
Stauder, R.
Vey, N.
Walter, R. B.
Wang, E.
Nier, S.
Martins, C. G.
Ossenkoppele, G.
Palmieri, R.
Maurillo, L.
Röllig, C.
Wierzbowska, A.
de Leeuw, D.
Efficace, F.
Curti, A.
Ngai, L. L.
Tettero, J.
Adès, L.
Almeida, A.
Bullinger, L.
Dennis, M.
Esteve, J.
Ferrara, F.
Heuser, M.
Huls, G.
Lübbert, M.
Mehta, P.
Montesinos, P.
Pabst, T.
Récher, C.
Rossi, G.
Russell, N.
Sierra, J.
Stauder, R.
Vey, N.
Walter, R. B.
Wang, E.
Nier, S.
Martins, C. G.
Ossenkoppele, G.
Description
Date
2025
Publisher
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Keywords
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Article
Citation
Venditti A, Palmieri R, Maurillo L, Röllig C, Wierzbowska A, de Leeuw D, et al. Fitness assessment in acute myeloid leukemia: recommendations from an expert panel on behalf of the European LeukemiaNet. Blood advances. 2025 May 13;9(9):2207-20. PubMed PMID: 39913928. Pubmed Central PMCID: PMC12083920 Pharmaceuticals, and consultancy for Amgen, Servier, AstraZeneca, Pfizer, Kite-Gilead, AbbVie, Janssen, Astellas, Astex, Otzuka, Stemline Menarini, Bristol Myers Squibb, Glycostem, Novartis, and Delbert (all are not related to this manuscript). R.P. reports speakers bureau participation with AbbVie, Janssen, Jazz, Pfizer, Astellas, Novartis, and Sobi; and served as consultant for Janssen and AbbVie (all are not related to this manuscript). C. Röllig reports institutional research funding from AbbVie, Novartis, and Pfizer; and advisory honoraria from AbbVie, Astellas, Bristol Myers Squibb, Jazz, Janssen, Novartis, Otsuka, Pfizer, and Servier (all are not related to this manuscript). D.d.L. reports consultancy for Servier, Roche, and AbbVie; and scientific advisory board participation for Takeda and Servier (all are not related to this manuscript). F.E. reports consultancy or advisory role for AbbVie, Incyte, Novartis, and Jazz Pharmaceuticals; and research funding (institution) from Daiichi Sankyo (all are not related to this manuscript). A.C. reports advisory board role for AbbVie, Novartis, and Menarini-Stemline; and research support from AbbVie (all are not related to this manuscript). A.A. reports honoraria from AbbVie, Bristol Myers Squibb, and Novartis (all are not related to this manuscript). L.B. reports honoraria from AbbVie, Amgen, Astellas, Bristol Myers Squibb, Celgene, Daiichi Sankyo, Gilead, Hexal, Janssen, Jazz Pharmaceuticals, Menarini, Novartis, Pfizer, Roche, and Sanofi; and research support from Bayer and Jazz Pharmaceuticals (all are not related to this manuscript). J.E. reports participation in advisory boards of AbbVie, Novartis, Astellas, Jazz Pharmaceuticals, Bristol Myers Squibb–Celgene, Pfizer, and Amgen; and research grants from Novartis, Jazz Pharmaceuticals, and Pfizer (all are not related to this manuscript). M.H. reports research funding to institutions from AbbVie, Servier, Astellas, BerGenBio, Glycostem, Jazz Pharmaceuticals, Karyopharm, Loxo Oncology, Novartis, and PinotBio (all are not related to this manuscript). P. Mehta reports speaker/advisory fees from AbbVie, Astellas, Daiichi Sankyo, Jazz Pharmaceuticals, Menarini, and Pfizer. P. Montesinos reports receiving research support, consultancy fees, speakers bureau fees, and advisory board membership from Agios, Astellas, AbbVie, Pfizer, Daiichi-Sankyo, Tolero Pharmaceuticals, Incyte, Novartis, Forma Therapeutics, GlycoMimetics, Bristol Myers Squibb/Celgene, Janssen, Karyopharm, Sanofi, Servier, Syndax, and Teva (all are not related to this manuscript). C. Récher reports consulting or advisory role with AbbVie, Amgen, Astellas, Bristol Myers Squibb, Boehringer, Jazz Pharmaceuticals, and Servier; received research funding from AbbVie, Amgen, Astellas, Bristol Myers Squibb, Iqvia, and Jazz Pharmaceuticals; and received support for attending meetings and/or travel from AbbVie, Novartis, and Servier. N.V. received honoraria from AbbVie, Amgen, Bristol Myers Squibb/Celgene, Daiichi, Novartis, and Roche; reports consultancy with Novartis, Janssen, Biokinesis, and Servier; and reports research grants from Bristol Myers Squibb, Jazz, and Innate Pharma. R.B.W. received laboratory research grants and/or clinical trial support from Aptevo, Celgene, ImmunoGen, Janssen, Jazz, Kite, Kura, and Pfizer; has ownership interests in Amphivena; and is (or has been) a consultant to AbbVie, Adicet, Amphivena, BerGenBio, Bristol Myers Squibb, GlaxoSmithKline, ImmunoGen, Kura, Orum, and Wugen (all are not related to this manuscript). E.W. reports advisory/consulting role with AbbVie, Bristol Myers Squibb, CTI Biopharma, Blueprint, Immunogen, Kite, Kura, Johnson & Johnson, Qiagen, Rigel, Schrodinger, Daiichi Sankyo, Gilead, GlaxoSmithKline, Stemline, Syndax, Novartis, NuProbe, Rigel, Schrodinger, and Sellas; reports speaking for Pfizer, Astellas, and Dava; and served on the data safety and monitoring committee of AbbVie and Gilead (also research scholar award committee; all are not related to this manuscript). The remaining authors declare no competing financial interests. Epub 2025/02/06 23:00. eng.