Evidence map›Paper›PMID 41538293›Full record

SynthesisBlood advances2026

Antileukemic therapies for older adults with AML ineligible for conventional therapy: systematic review and meta-analysis.

Maria Jose Oliveros, Saifur R Chowdhury, Yetiani Roldan, Sara Ibrahim, Gonzalo Bravo-Soto, Charles E Foucar, Gurleen Bhogal, Barbara Burgos-Mansilla, Mobina Bagherianlemraski, Hamed Movahed and 16 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Blood advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors.

Maria Jose OliverosDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0002-9327-6844
Saifur R ChowdhuryDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0003-4361-0792
Yetiani RoldanDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0009-0009-4564-5973
Sara IbrahimDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0002-7713-6171
Gonzalo Bravo-SotoDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0003-3111-3975
Charles E FoucarUniversity of New Mexico Comprehensive Cancer Center, Albuquerque, NM.
Gurleen BhogalFaculty of Dentistry, University of Toronto, ON, Canada.ORCID 0009-0006-6399-936X
Barbara Burgos-MansillaDepartamento de Ciencias de la Rehabilitación, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile.ORCID 0000-0002-3100-5491
Mobina BagherianlemraskiDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0002-3369-4948
Hamed MovahedDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Ruvistay Gutierrez-AriasDepartamento de Apoyo en Rehabilitación Cardiopulmonar Integral, Instituto Nacional del Tórax, Santiago, Chile.
Tanin Khorrami TajSchool of Interdisciplinary Science, McMaster University, Hamilton, ON, Canada.
Yaping ChangDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
Seyed Kaveh HadeiyEmergency Department, Bahari Hospital, Hamedan University of Medical Sciences, Hamedan, Iran.ORCID 0000-0002-9104-971X
Rachel CoubanDepartment of Anesthesia, McMaster University, Hamilton, ON.ORCID 0000-0001-8672-2845
Roberta Demichelis-GomezInstituto Nacional de Ciencias Médicas y Nutrición Salvador, Mexico City, Mexico.ORCID 0000-0003-0258-7397
Luca MalcovatiDepartment of Molecular Medicine, University of Pavia and S. Matteo University Hospital Foundation, Pavia, Italy.ORCID 0000-0002-1460-1611
Kah Poh LohDivision of Hematology and Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY.
Uwe PlatzbeckerDepartment of Internal Medicine, University Hospital Carl Gustav Carus, Dresden, Germany.ORCID 0000-0003-1863-3239
Linda GilbertoJacksonville, FL.
John TreitzLouisville, KY.
Maria R BaerUniversity of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD.
Bernard L MariniUniversity of Michigan College of Pharmacy, Ann Arbor, MI.ORCID 0000-0003-0436-8948
Ryan MattisonDivision of Hematology, Medical Oncology and Palliative Care, University of Wisconsin-Madison, Madison, WI.
Mikkael A SekeresSylvester Comprehensive Cancer Center, University of Miami, Miami, FL.ORCID 0000-0003-2009-6524
Romina Brignardello-PetersenDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.ORCID 0000-0002-6010-9900

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

abstractOlder adults with newly diagnosed acute myeloid leukemia (AML) are often ineligible for conventional "7+3" induction chemotherapy. Despite recent drug approvals, treatment outcomes remain poor in this population. We conducted an updated systematic review to inform the 2025 American Society of Hematology (ASH) AML update guidelines in older adults. This review compared the efficacy and safety of low-dose cytarabine (LDAC), azacitidine (AZA), 5- and 10-day decitabine (DEC), and gemtuzumab ozogamicin, alone or combined with drugs such as venetoclax (VEN), in older adults with AML ineligible for conventional chemotherapy. We included randomized controlled trials (RCTs) and nonrandomized studies (NRSs) of adults aged ≥55 years with AML, and synthesized evidence on mortality, remission, quality of life (QoL), functional status, and severe toxicity. We applied GRADE (grading of recommendations assessment, development, and evaluation) to assess the certainty of evidence. We included 47 studies (30 RCTs and 17 NRSs). AZA or LDAC combined with VEN probably reduces mortality and improves remission and QoL. AZA plus isocitrate dehydrogenase 1 (IDH1) inhibitors may reduce 1-year mortality and improve remission and survival in patients with IDH1-mutated AML. Compared with DEC alone, combining DEC with other agents showed inconsistent effects with mostly low certainty of conclusions. VEN combinations showed promising effects on mortality and remission but lacked data on QoL and functional status. In older adults with AML ineligible for conventional therapy, evidence suggests that hypomethylating agents or LDAC combined with VEN likely improves survival and remission outcomes. Treatment decisions should consider patient goals and functional status. These findings informed 8 recommendations in updated ASH-AML guidelines.

Indexed as

Antineoplastic AgentsAntineoplastic Combined Chemotherapy ProtocolsLeukemia, Myeloid, AcuteAgedHumansQuality of LifeTreatment OutcomeAntineoplastic Agents

Identifiers

PMID41538293
PMCPMC13261943

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.