AML in Older Adults (≥55 Years) No Longer Receiving Antileukemic Therapy — End-of-Life and Hospice Care

This protocol addresses acute myeloid leukemia in older adults aged 55 years or older who have stopped antileukemic therapy, including those enrolled in end-of-life care or hospice care.

Clinical scenario: Older adult (≥55 years) with AML who is no longer receiving antileukemic therapy, including patients in end-of-life care or hospice care.

The recommended approach in this setting centres on ensuring a specific form of transfusion support remains available — the full protocol details which product, under what circumstances, and addresses a separate consideration that applies only in rare situations.

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References

DOI: 10.1182/bloodadvances.2025017934

For older adults with AML who are no longer receiving ALT (including those receiving end-of-life care or hospice care), the ASH guideline panel suggests having RBC transfusions be available over not having transfusions be available (conditional recommendation based on very low certainty in the evidence of effects ⨁◯◯◯).

There may be rare instances in which platelet transfusions may be of benefit in the event of bleeding, but there are even less data to support this practice and it is anticipated that platelet transfusions will have little or no role in end-of-life or hospice care.

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