Managing AML in older adults can be challenging on a number of levels. While the majority of this population will not enjoy long-term disease-free survival because of disease features and treatment-related complications, a small subset will derive a survival benefit from aggressive chemotherapy approaches. Factors such as functional age can be used to assess which patients might benefit from remission induction and postremission therapy, and which would be done a disservice with such treatment. Studies are needed to assess the trade-off between the slim chance of long-term survival that might be attained with chemotherapy and the quality-of-life issues of low-dose or aggressive supportive therapy.

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