biostudies-literatureOnate GMinistry of Economy and Competitiveness | Instituto de Salud Carlos III (Institute of Health Carlos III)Departament d'Innovació, Universitats i Empresa, Generalitat de Catalunya (Department of Innovation, Education and Enterprise, Government of Catalonia)4https://www.ebi.ac.uk/biostudies/studies/S-EPMC11724937biostudies-literatureUnknown15(1)Given the heterogeneity of acute myeloid leukemia patients, it is necessary to identify patients considered fit for intensive therapy but who will perform poorly, and in whom alternative approaches deserve investigation. We analyzed 1034 fit adults ≤70 years intensively treated between 2012 and 2022 in the CETLAM group. Young adults ( ≤ 60 years) presented higher remission rates and improved survival than older adults above that age (CR 79% vs. 73%; p = 0.03 and 4-yr OS 53% vs. 33%; p < 0.001). Remission and survival outcomes varied among different genetic subsets. An especially adverse genetic group included complex, monosomal karyotype, TP53 alterations (deleted/mutated), and MECOMr. Transplant feasibility in this very adverse risk group was low, and OS and EFS at 4 years were 14% and 12Blood cancer journalDiverse real-life outcomes after intensive risk-adapted therapy for 1034 AML patients from the CETLAM Group.PMC11724937PI20/01621PI17/01246SGR 01139 2021PERIS SLT00433Ortin XGarrido ATormo MNomdedeu JFArnan MEsteve JPratcorona MAlonso EVall-Llovera FGarcia-Avila SZamora LSampol AOnate GGuijarro FVives SGarcia ASalamero OIranzo ESierra JDiaz-Beya MPomares HColl RCervera MBargay JfalseDiverse real-life outcomes after intensive risk-adapted therapy for 1034 AML patients from the CETLAM Group.Given the heterogeneity of acute myeloid leukemia patients, it is necessary to identify patients considered fit for intensive therapy but who will perform poorly, and in whom alternative approaches deserve investigation. We analyzed 1034 fit adults ≤70 years intensively treated between 2012 and 2022 in the CETLAM group. Young adults ( ≤ 60 years) presented higher remission rates and improved survival than older adults above that age (CR 79% vs. 73%; p = 0.03 and 4-yr OS 53% vs. 33%; p < 0.001). Remission and survival outcomes varied among different genetic subsets. An especially adverse genetic group included complex, monosomal karyotype, TP53 alterations (deleted/mutated), and MECOMr. Transplant feasibility in this very adverse risk group was low, and OS and EFS at 4 years were 14% and 122025-01-01T00:00:00Z2025 Jan2026-06-01T06:02:40.673Z2026-04-08T09:49:07.807ZS-EPMC117249373979914510.1038/s41408-024-01205-5