Approximately 80% of patients with diffuse large B-cell lymphoma achieve a complete response following chemoimmunotherapy as defined by PET scan. However, not all patients who fail to achieve a metabolic complete response are destined to relapse. In a number of these patients, the PET scan is falsely positive (i.e., 20%-40% in several large series), particularly when the PET scan score is Deauville 4. Reflexively intervening with salvage systemic therapy or radiotherapy in these patients is potentially harmful. It appears that very sensitive measurements of circulating tumor DNA might be able to differentiate between patients who are unlikely to relapse and those with residual lymphoma. It is important to remember that lymphoma is not the only condition that can make a PET scan abnormal and to consider alternate diagnosis that should be managed differently.

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare lymphoma subtype, representing a small fraction of Hodgkin lymphoma or an even smaller fraction of B-cell non-Hodgkin lymphoma, depending on the classification schema used. NLPHL is characterized by rare lymphocyte-predominant (LP) cells interspersed within a complex immunologic architecture. NLPHL immunoarchitecture has led to hypothesis-driven research suggesting the pathogenesis of NLPHL may be driven by aberrant immune responses to commensal microorganisms, including Moraxella catarrhalis and Rothia mucilaginosa. NLPHL commonly presents in younger adults with asymptomatic lymphadenopathy in early stages. Although late relapses are a well-known feature of this disease, the prognosis is outstanding, nearly mirroring the average life expectancy in Western populations. Management options must carefully weigh the benefits of treatment against the risks of long-term toxicities, including end-organ damage and secondary malignancies. Options utilizing least-toxic approaches include active surveillance, radiation therapy, and combination chemoimmunotherapy for higher-risk presentations. A recent prognostic score, the LP-IPS, derived from large multicenter datasets, may help personalize approaches for patients at higher risk of morbidity/mortality requiring therapy and identify lower-risk patients for active surveillance or low-toxicity approaches.

Acute myeloid leukemia (AML) poses complex management challenges and requires specialized care. Academic cancer centershave multidisciplinary teams, offer rapid and advanced diagnostics, and provideaccess to novel therapies. Community cancer centers provide care closer to home, especially for underserved and rural populations, but their resources and expertise vary. Effective collaboration between academic and community cancer centerscanimproveaccess to advanced therapies, reduce treatment disparities, and bringcare closer to home. However, barriers such as delayed referrals, resource constraints, and communication gaps complicate collaboration.Timely referral to academic centers for leukemia emergencies and serious complications is critical. Bidirectional communication, including shared electronic health records and telemedicine, is essential when patients are co-managed across centers. System-level strategies, such as referral networks, patient navigators, and transportation assistance, can further address these challenges. Developing integrated care models and standardized guidelines will enhance collaboration, enabling high-quality personalized care for individuals with AML.

Importance:Achieving remission is the first step toward a cure in treating aggressive B-cell lymphomas. Radiographic imaging, such as fluorodeoxyglucose-positron emission tomography/computed tomography scans are the current standard to define remission at the end of therapy but lack specificity for lymphoma and cannot detect disease at the molecular level. Identifying measurable residual disease with ultrasensitive detection of circulating tumor DNA potentially offers the possibility of improving clinical outcomes. Observations:Early studies of circulating tumor DNA in aggressive B-cell lymphomas showed a strong association with overall tumor burden, and baseline quantitative levels are associated with clinical outcomes after frontline chemotherapy. Next-generation sequencing methods that detect lymphoma-relevant genetic aberrations in circulating tumor DNA can also be used for noninvasive genotyping that strongly mirror tissue biopsies. Rapid changes in circulating tumor DNA dynamics after 1 or 2 cycles of frontline chemotherapy or within weeks of treatment with chimeric antigen receptor T-cell salvage therapy are also highly prognostic. Although serial monitoring of circulating tumor DNA can detect molecular relapse 3 to 6 months before clinical relapse, improved analytical thresholds are required to detect measurable residual disease at a singular point at the end of therapy. Modern advances in circulating tumor DNA methods now allow for the reliable detection of measurable residual disease, with an analytical detection threshold of 1 in 1 million cell-free DNA molecules. Conclusions and Relevance:The results of this review suggest that modern ultrasensitive methods of detecting circulating tumor DNA may improve the current definition of remission in aggressive B-cell lymphomas. Incorporating circulating tumor DNA at the end of therapy assessment identifies patients who do not require surveillance monitoring and introduces paradigms of treating measurable residual disease within clinical trials. Practical barriers, including standardization of collection, availability, turnaround times, and cost, remain hurdles preventing widespread implementation into clinical practice.

How to select the appropriate intensity of chemotherapy in older adults with acute myeloid leukemia (AML) remains an unanswered question. In a phase II trial of older adults ≥ 60 years with AML (n = 73), we used geriatric assessment (measures of comorbidity burden, physical and cognitive function) to determine fitness for intensive chemotherapy. We integrated the geriatric assessment and genetic test results to personalize the selection of chemotherapy intensity with a goal to reduce early mortality (NCT03226418). Broad eligibility criteria allowed enrolling patients representative of those treated in real-world practices: 45% of patients were ≥ 70 years, 57% had ≥ 2 comorbidities, 27% had a history of solid malignancies, and 74% had impairments in ≥ 2 geriatric assessment domains used to assign treatment intensity. Thirty-two percent of patients resided in rural areas, and 45% were comanaged with community oncologists. The median time from enrollment to therapy initiation was 1 day (range 0-13). Eight patients (11%) received intensive chemotherapy; others received low-intensity chemotherapy. Mortality at 30 days from diagnosis was 6.8% (95% confidence interval, CI 3.0%-15.1%) and at 90 days was 21.9% (95% CI 14.0%-32.7%). One-year survival was 45.9% (95% CI 35.6%-59.3%). Our study demonstrates that pre-treatment geriatric assessment in older adults with AML is feasible, can identify several functional impairments, and guide the selection of treatment intensity. A randomized trial is necessary to confirm the survival benefit of this approach over the traditional approach of treatment selection. Trial Registration: NCT03226418.

Introduction Chimeric antigen receptor (CAR)-T cell therapy is associated with a well-described neurotoxicity side effect termed immune effector-cell associated neurotoxicity syndrome (ICANS) in the immediate post-infusion period that patients largely recover from. The incidence of ICANS varies depending on lymphoma type, tumor burden and type of CAR-T product infused (axicabtagene ciloleucel (axi-cel), lisocabtagene maraleucel (liso-cel) and tisagenlecleucel (tisa-cel)). It is unclear if there are any chronic neurological problems that result from experiencing ICANS in the immediate post-infusion period. The purpose of our study was to determine the long-term risk for neurocognitive dysfunction after CAR-T cell infusion. We hypothesized that patients who experienced ICANS would have a greater incidence of self-reported cognitive dysfunction one year or longer after CAR-T therapy than patients who did not experience ICANS. Methods To test this hypothesis, we performed a single center prospective study of patient-reported neurocognitive performance. All patients with B-cell non-Hodgkin's lymphoma over one year from receipt of CAR T-cell therapy were eligible to participate. Neurocognitive performance was evaluated using two different patient-reported outcome measures (PROMs) surveys (Neuro-QOL v2.0 cognitive form and the Neuro-QOL positive affect and well-being form) that were administered over the phone. Patient medical records were reviewed for additional risk factors of interest including Eastern Cooperative Oncology Group (ECOG) score, cytokine release syndrome (CRS) grade, ICANS grade, lymphoma subtype, and disease status. CRS and ICANS were graded using the American Society for Transplantation and Cellular Therapy (ASTCT) criteria. The primary outcomes were Neuro-QOL v2.0 cognitive t-score and Neuro-QOL positive affect and well-being t-score. Higher scores correlate with higher cognitive performance and well-being. T-tests were used to examine differences in ICANS (Grade 0 vs 1-4), gender (male vs female), race (Caucasian vs not Caucasian), and CAR-T therapy (axi-cel vs tisa-cel/liso-cel). A general linear model was used to examine difference in CRS grade (no CRS vs grade 1 vs grade 2). Results Twenty patients participated. Three had ICANS grade 1 (15%), 3 ICANS grade 2 (15%) , 2 ICANS grade 3 (10%), and 1 ICANS grade 4 (5%). Eleven did not experience ICANS (55%) .Six (30%) were female. Seventeen (85%) were Caucasian. Fourteen (70%) received Axi-cel ,one (5%) received Tisa-cel and five (25%) received Liso-cel. Patients who had any grade ICANS scored 43.18 + 8.39 on the Neuro-QOL cognitive survey and 54.57 + 7.03 on the well-being survey vs patients without ICANS scored 50.59 + 10.08 on the Neuro QOL cognitive survey and 57.39 + 5.15 on the well-being survey (P = 0.09 and 0.31 respectively). Axi-cel patients scored 48.53 +10.20 on the Neuro-QOL cognitive survey and 56.06 + 5.88 on the well-being survey vs. tisa-cel/liso-cel patients scored 44.28 + 9.19 on the Neuro QOL cognitive survey and 56.25 + 7.09 on the well-being survey (P = 0.39 and 0.95 respectively). No effect of CRS on neurocognitive outcomes was observed. Interestingly, female patients scored lower on both the neuro-QOL cognitive survey (43.67 + 11.90) and well-being survey (54.68 + 4.50) than male patients (48.79+ 8.91) and 56.74+6.69. P= 0.30 and 0.50 respectively. Conclusion Our study identified a non-statistically significant trend that patients experiencing ICANS toxicity may be at increased risk for long-term neurocognitive dysfunction. Given the limited sample size, additional subjects are being recruited to further evaluate for statistically significant differences. This analysis is ongoing at our institution as more subjects become eligible and data will be updated accordingly.

Improved maintenance treatments are needed for patients with relapsed/refractory aggressive lymphomas after autologous haematopoietic stem cell transplantation (ASCT). Several studies with lenalidomide have been found to have activity in the treatment of relapsed/refractory aggressive lymphomas. In the present phase I/II, single-arm, open-label study, 59 patients with high-risk relapsed non-Hodgkin lymphoma received pretransplant BEAM chemotherapy and ASCT followed by 12 months of maintenance lenalidomide once daily on Days 1-21 (28-day cycles) beginning at post-transplantation Day 100. The most common histologies were mantle cell lymphoma (56%) and diffuse large B-cell lymphoma (24%). The maximum tolerated dose in the dose-finding part of the study was 15 mg, but cytopenias led to the subsequent adoption of a 10 mg dose in the final study. Sixteen patients (27%) completed 12 cycles of lenalidomide maintenance. The most common reason for discontinuation was adverse events (31%). These were primarily haematologic, and 56% of patients experienced Grade 3-4 events. Two-year PFS rates (95% CIs) were 70% (56%-80%), 45% (19%-68%) and 81% (66%-90%); 2-year OS rates (95% CIs) were 91% (80%-96%), 93% (61%-99%) and 90% (76%-96%) in all patients, patients completing and patients not completing 12-month maintenance respectively. These results do not support the use of lenalidomide maintenance in this setting.

To find the optimal treatment for a disease it is necessary to identify specific biological and clinical entities that are as homogeneous as possible. The history of classifying lymphomas in a clinically useful way is a long and interesting story, beginning with Thomas Hodgkin’s initial clinical description. Landmarks along the way include the description of the Reed Sternberg cell that separated Hodgkin lymphoma, and a series of classification systems to subdivide the other lymphomas. These include the Gall and Mallory classification (i.e., reticulum cell sarcoma, lymphosarcoma, and giant follicular lymphoma), The Rappaport classification (i.e., based on cell size, shape, and growth pattern), That Lukes- Collins and Kiel classifications (i.e., that subdivided T cell and B cell lymphomas and recognized that all lymphomas originate in lymphocytes), and the working formulation (i.e., a politically driven attempt to standardize terminology and facilitate research and treatment). More recently the REAL classification began the process of identifying specific entities taking into account clinical/pathological syndromes including new genetic information. This approach was adopted by the WHO classification. We now have a new issue to resolve- that is, the relative merits of the new WHO classification versus the ICC classification. This presentation will compare and contrast these two approaches looking for particular strengths or weaknesses. We must always ask if the proposals are scientifically valid, reproducible by pathologists, and clinically relevant. Either way this will not be the last lymphoma classification as new insights into the biology of the diseases and identification of treatment targets will, hopefully, make our treatments more specific and more effective. Keyword: pathology and classification of lymphomas No conflicts of interests pertinent to the abstract.

INTRODUCTION:Many older adults with acute myeloid leukemia (AML) do not receive chemotherapy because of physicians' and patients' concern for toxicities and functional decline. This highlights the critical and urgent need to generate knowledge of functional changes following new treatments. MATERIALS AND METHODS:As a part of a pragmatic single-center trial, 59 older adults ≥60 years with AML completed geriatric assessment and health-related quality of life measures before treatment and at one month and three months after chemotherapy initiation. Changes in scores of various geriatric assessment measures were computed by subtracting the baseline score from the one-month and three-month scores for each patient. Established cut-offs were used to determine a clinically meaningful change (improvement or worsening). This study provides results of descriptive exploratory analyses. RESULTS:Patients experienced significant comorbidity burden and a high prevalence of functional impairments before treatment, with 56% of patients having ≥2 comorbid conditions, 69% having abnormal cognitive function (using Montreal Cognitive Assessment), 69% having impaired objective physical function (using Short Physical Performance Battery), and 64% having a positive depression screen (Patient Health Questionnaire-9). Patients (n = 53) received treatment with predominantly low-intensity chemotherapy; six patients received intensive chemotherapy. Among those who completed some or all of the three-month evaluation (N = 43), from baseline before treatment to three months later, cognitive function improved (38.7%) or remained stable (38.7%), objective physical function improved (51.6%) or remained stable (22.6%), and depression scores improved (9.4%) or remained stable (53.1%). Global health status score and role functioning moderately improved by a score of >16. DISCUSSION:An exploratory analysis of our phase 2 trial demonstrated improvement or stabilization of cognitive and physical function and depression score at three months in a high proportion of older survivors of AML, despite a high prevalence of frailty and significant comorbidity burden at baseline. These results demonstrate success of treatment in improving cognitive and physical function and depression score, and, if confirmed in larger studies, should encourage oncologists to offer chemotherapy to older adults with AML. CLINICAL TRIAL REGISTRATION:The study is registered in the ClinicalTrials.gov ID: NCT03226418.

ALK-positive anaplastic large cell lymphoma (ALCL) represents approximately 6-7% of the mature T-cell lymphomas. This subtype contains a translocation between the ALK gene on chromosome 2 and one of several other genes that together form an oncogene. The most frequent translocation is t(2;5) which combines ALK with NPM1. This lymphoma has a median age of 34 years, is more common in males, and is in advanced stage at the time of diagnosis in most patients. ALK-positive ALCL is the most curable of the peripheral T-cell lymphomas. The CHOP regimen has been most frequently used, but results are improved with the substitution of brentuximab vedotin for vincristine (BV-CHP) and the addition of etoposide (CHOEP), with BV-CHP being favored. Salvage therapies include allogeneic or autologous bone marrow transplantation, BV, if not used as part of the primary therapy, and ALK inhibitors. The latter are very active and likely to be incorporated into the primary therapy.

Background Patients with mantle cell lymphoma (MCL) exhibit a wide variation in clinical presentation and outcome. However, the commonly used prognostic models are outdated and inadequate to address the needs of the current multidisciplinary management of this disease. This study aims to investigate the clinical and pathological features of MCL in the immunochemotherapy era and improve the prognostic models for a more accurate prediction of patient outcomes.Methods The North American Mantle Cell Lymphoma Project is a multi-institutional collaboration of 23 institutions across North America to evaluate and refine prognosticators for front-line therapy. A total of 586 MCL cases diagnosed between 2000 and 2012 are included in this study. A comprehensive retrospective analysis was performed on the clinicopathological features, treatment approaches, and outcomes of these cases. The establishment of novel prognostic models was based on in-depth examination of baseline parameters, and subsequent validation in an independent cohort of MCL cases.Results In front-line strategies, the use of hematopoietic stem cell transplantation was the most significant parameter affecting outcomes, for both overall survival (OS, p < 0.0001) and progression-free survival (PFS, p < 0.0001). P53 positive expression was the most significant pathological parameter correlating with inferior outcomes (p < 0.0001 for OS and p = 0.0021 for PFS). Based on the baseline risk factor profile, we developed a set of prognostic models incorporating clinical, laboratory, and pathological parameters that are specifically tailored for various applications. These models, when tested in the validation cohort, exhibited strong predictive power for survival and showed a stratification resembling the training cohort.Conclusions The outcome of patients with MCL has markedly improved over the past two decades, and further enhancement is anticipated with the evolution of clinical management. The innovative prognostic models developed in this study would serve as a valuable tool to guide the selection of more suitable treatment strategies for patients with MCL.

Introduction: Geriatric assessment can predict the risk of toxicities of chemotherapy in older adults. Genetic risk categories correlate with survival following intensive chemotherapy in AML. Integrating geriatric assessment for patient profiling and genetic profiling of leukemic cells represents an innovative precision medicine approach to personalize therapy selection in older adults with AML. We report results of a pre-planned interim analysis of a pragmatic phase II trial using such strategy that has an overarching goal to reduce early mortality (NCT03226418). Methods: Patients ≥60 years with a new diagnosis of AML underwent geriatric assessment prior to initiation of treatment. Geriatric assessment of physical function, cognitive function and comorbidity burden were used to determine fitness for intensive chemotherapy (Table 1). Additional assessment included Karnofsky Performance Scale (KPS), Patient Health Questionnaire-9 (PHQ-9), and Mini Nutritional Assessment-Short Form (MNA). Genetic profiling for therapy selection relied on karyotyping and followed the 2017 European LeukemiaNet criteria. While available mutation test results were incorporated to risk stratify, the study did not require to wait for the results prior to therapy initiation given an anticipated turnaround time of 1-2 weeks for mutation test results. Therapy selection followed the algorithm demonstrated in Figure 1. Patients with good or intermediate-risk AML received intensive chemotherapy such as 7+3 +/- gemtuzumab or midostaurin if determined to be fit. Patients with high-risk AML received low-intensity chemotherapy such as a hypomethylating agent with or without novel drugs, or CPX 351 if they were fit and met the FDA-approved indications. Patients with organ dysfunction (e.g. creatinine ≥2 mg/dl) and those requiring chemotherapy for other malignancy received low-intensity chemotherapy. Chemotherapy at diagnosis or follow up could be administered in community oncology settings. Patients were followed for assessment of quality of life, functional and oncologic outcomes. Results: Between July 2017-June 2019, a total of 31 patients (including 1 MDS patient considered screen failure) were enrolled. The pre-planned interim analysis results are based on the first 27 AML patients. Baseline characteristics included a median age of 70 years (range 60-84 years), 56% female, 96% white, and a median KPS of 80% (range 60-100%). As presented in Table 1, over half of the patients had ≥3 comorbidities, impairment in objective physical function (short physical performance battery) and Montreal Cognitive Assessment. Additionally, 67% had poor nutritional status (MNA score of ≤11) and 26% had abnormal depression screen (PHQ-9 score of ≥10). Risk categories included adverse (64%), intermediate (16%), and good-risk AML (20%). Patients had one or more of the following mutations: FLT3 ITD (11%), NPM1 (22%), biallelic CEBPA (4%), IDH1 (15%), IDH2 (8%), RUNX1 (15%), ASXL1 (22%), and TP53 (19%). Three patients received intensive chemotherapy; CPX 351 (n=2) or 7+3+ gemtuzumab (n=1). Other patients received decitabine or azacitidine alone (n=16), azacitidine and venetoclax (n=5) or decitabine and midostaurin (n=3). The median time from diagnosis to therapy initiation was 7 days (0-20 days) whereas the median time from enrollment to therapy initiation was 2 days (range 0-9). Mortality at 30 days from diagnosis was 3.7% (95% confidence interval, CI 0.7-18.3%) and at 90 days was 29.6% (95% CI 15.9-48.5%). Mortality compared favorably to an unmatched historical cohort of patients ≥60 years treated at our center between 2011-2016, where 30-day mortality was 30% (95% CI 22-40%) and 90-day was 41% (95% CI 32-52%) (Future Oncol. 2019;15:1989-95). Conclusions: Our model to personalize AML therapy selection represents an innovative approach to precision medicine that incorporates both geriatric assessment for patient profiling and genetic profiling of leukemia cells. Geriatric assessment demonstrated high frequency of impairment in objective physical and cognitive function. Patients were able to start therapy within a median of 2 days following enrollment. Pragmatic aspects of the trial included broad eligibility criteria and co-management of patients with community oncologists. Our pre-planned interim analysis data appear promising with lower rates of early mortality compared to unmatched historical controls. Disclosures Bhatt: Pfizer: Consultancy; CSL Behring: Consultancy; Agios: Consultancy; Abbvie: Consultancy; Partner therapeutics: Consultancy; Incyte: Consultancy, Research Funding; Tolero Pharmaceuticals: Research Funding; National Marrow Donor Program: Consultancy. Al-Kadhimi:Celldex Biotech: Other: Stocks; Seattle Genetics: Other: Stocks. Armitage:Oncology Analytics: Consultancy; Partner Therapeutics: Consultancy; Samus Therapeutics: Consultancy; Ascentage: Consultancy; Tesaro bio: Membership on an entity's Board of Directors or advisory committees; Union Pacific: Consultancy. Holstein:GSK: Consultancy; Genentech: Membership on an entity's Board of Directors or advisory committees; Sorrento: Consultancy; Celgene: Consultancy; Takeda: Membership on an entity's Board of Directors or advisory committees; Adaptive Biotechnologies: Membership on an entity's Board of Directors or advisory committees. Gundabolu:Samus Therapeutics: Research Funding; Jazz pharmaceuticals: Consultancy; Pfizer: Consultancy; Novartis: Consultancy. OffLabel Disclosure: Single agent azacitidine and decitabine as well as decitabine in combination with midostaurin are not approved by the US FDA for acute myeloid leukemia.

Snakebites Snake envenomation is a global health problem. The range of clinical sequelae includes thromboses and neuromuscular paralysis. Antivenoms made in horses and sheep are the treatments of choice but require accurate identification of the bite source and can cause anaphylaxis and serum sickness.

Background: Over one-third of older adults with AML do not receive chemotherapy because of fear of toxicities and functional decline. This highlights the critical and urgent need to generate knowledge of functional changes following newer treatments. Methods: As a part of a pragmatic single-center phase II investigator-initiated trial (ClinicalTrials.gov ID: NCT03226418), we enrolled older adults (≥60 years) with a new diagnosis of AML. We repeated geriatric assessment (GA) and health-related quality of life (HRQOL) before and 3 months after chemotherapy initiation. GA included measures of physical function (e.g. short physical performance battery or SPPB), Montreal Cognitive Assessment (MoCA), Hematopoietic Cell Transplantation Comorbidity Index, Patient Health Questionnaire-9 (PHQ-9), Mini Nutritional Assessment-Short Form. Frailty was defined as impairment in 2 or more domains on geriatric assessment (excluding MoCA). HRQOL was measured using European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C-30 (v 3.0). Established cutoffs were used to determine a clinically meaningful change in various measures from baseline to 3 months. Results: 59 eligible patients were enrolled and had median age of 69 years and median KPS of 80. Patients received treatment with predominantly low-intensity chemotherapy (hypomethylating agent +/-venetoclax or midostaurin); six patients received intensive chemotherapy. 56% of patients had ≥2 comorbid conditions, and 69% each had impaired MoCA scores and impaired objective physical function at baseline. Whereas 29% had an established diagnosis of depression or anxiety, 66% had abnormal PHQ-9 with a score of 5 or more. 61% had impaired nutritional screen. A total of 43 patients completed some or all of the optional follow-up assessments at 3 months. Cognitive function or MoCA scores improved (64.5%) or stabilized (9.6%) from baseline to 3 months after treatment (Figure 1). We also noted improvement (51.6%) or stabilization (22.6%) in objective physical function (Figure 2). PHQ-9 scores showed improvement or stabilization in about 90% of patients. Nutritional scores showed variable changes with 40% demonstrating improvement. On HRQOL assessment, global health status score, and role functioning moderately improved from baseline to three-month after enrollment. Longitudinal cognitive function over 3 months differed based on the presence of frailty and multimorbidity (≥2 comorbid conditions) at baseline. Improvement in MoCA scores was noted in 31.8% (95% CI 16.4-52.7%) and 50.0% (95% CI 23.7-76.3%) of patients with versus without baseline frailty. The risk of worsening of cognitive function was 31.5% (95% CI 15.4-54.0%) for patients with multimorbidity at baseline versus 16.7% (95% CI 4.7-44.8%) for those without. Conclusion: We demonstrated an overall improvement or stabilization of functional status and HRQOL in a high proportion of older adults with AML, despite high prevalence of functional impairments and significant comorbidity burden at baseline. These results should encourage oncologists to offer chemotherapy even to older adults with multiple comorbid conditions or poor functional status at the time of diagnosis of AML. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal