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

Despite recent drug approvals, treatment outcomes remain poor in this population.

尽管最近有新药批准，但这一人群的治疗结果仍然较差。

We conducted an updated systematic reviewto inform the 2025 American Society of Hematology (ASH) AML update guidelines in older adults.

我们进行了一项更新的系统综述，以提供2025年美国血液学会（ASH）老年急性髓性白血病（AML）更新指南的信息。

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.

这项综述比较了低剂量阿糖胞苷（LDAC）、阿扎胞苷（AZA）、5天和10天地西他滨（DEC）以及单独或与药物如维奈克拉（VEN）联合使用的吉妥单抗奥佐米星，在不适合常规化疗的老年AML患者中的疗效和安全性。

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.

我们纳入了针对55岁及以上成人急性髓细胞性白血病（AML）患者的随机对照试验（RCTs）和非随机研究（NRSs），并综合了关于死亡率、缓解、生活质量（QoL）、功能状态和严重毒性的证据。

We applied GRADE (grading of recommendations assessment, development, and evaluation) to assess the certainty of evidence.

我们应用了GRADE（推荐等级的评估、制定和评价）来评估证据的确定性。

We included 47 studies (30 RCTs and 17 NRSs).

我们纳入了47项研究（30项随机对照试验和17项非随机研究）。

AZA or LDAC combined with VEN probably reduces mortality and improves remission and QoL.

阿扎胞苷（AZA）或低剂量阿糖胞苷（LDAC）与维奈克拉（VEN）联合使用可能会降低死亡率，并改善缓解率和生活质量（QoL）。

AZA plus isocitrate dehydrogenase 1 (IDH1) inhibitors may reduce 1-year mortality and improve remission and survival in patients with IDH1-mutated AML.

AZA 加上异柠檬酸脱氢酶 1 (IDH1) 抑制剂可能会降低 IDH1 突变 AML 患者 1 年内的死亡率，并改善缓解率和生存期。

Compared with DEC alone, combining DEC with other agents showed inconsistent effects with mostly low certainty of conclusions.

与单独使用 DEC 相比，将 DEC 与其他药物联合使用显示出的效果不一致，且结论的确定性大多较低。

VEN combinations showed promising effects on mortality and remission but lacked data on QoL and functional status.

VEN联合疗法在死亡率和缓解率方面显示出有希望的效果，但缺乏关于生活质量（QoL）和功能状态的数据。

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.

对于不符合常规治疗条件的老年急性髓性白血病（AML）患者，证据表明低甲基化剂或低剂量阿糖胞苷（LDAC）与VEN联合使用可能会改善生存率和缓解结果。

Treatment decisions should consider patient goals and functional status.

治疗决策应考虑患者的目标和功能状态。

These findings informed 8 recommendations in updated ASH-AML guidelines.

这些发现为更新的ASH-AML指南提供了8条建议。