<title>Abstract</title> There is a limited information available on the clinical characteristics, treatment patterns and outcomes on older patients diagnosed with Acute Myeloid Leukemia (AML) in Latin-America. This multicenter retrospective study analyzed 269 patients over 60 years of age diagnosed with AML in Colombia, using data from RENEHOC-PETHEMA registry, from 2009 to 2023. The median age at diagnosis was 70 years (Range: 60–98), 55% were men, 61% had an ECOG < 2, and 75.5% had de novo AML. FLT3-ITD or NPM1 mutations were performed in 23.4% and 15.6% of patients, and detected in 14.3% and 16.7% of cases, respectively. Treatment included intensive chemotherapy (IC) (36.8%), non-intensive chemotherapy (non-IC) low dose cytarabine based chemotherapy (12.6%), hypomethylating agents (HMA, with/without venetoclax) (35.3%), and supportive care (15.2%). Median overall survival (OS) was 8.2 months (10.6 months after IC, 8.8 after non-IC, 8.9 months after HMA, 8.2 months after HMA plus venetoclax, and 1.9 months with supportive care). OS was 35.2% at 1 year and 5.6% at 5 years (13.7% treated with IC). Only 1.5% of patients were transplanted in frontline. Leukemia-free survival (LFS) was 17.6 month, with 67.6% survival at 1 year and 27.3% at 5 years. Among patients treated with IC, the 5-year LFS was 41.3%, and 0% for non-IC. A shift from IC to HMA plus venetoclax regimens was observed after venetoclax marketing. This study provides new insights into the management of patients in Colombia, highlighting the need for a highly individualized approach in treating AML in elderly patients.
