Review Articles
Vol. 18 No. 1 (2026): Mediterranean Journal of Hematology and Infectious Diseases
OPTIMIZATION OF THE CLINICAL JOURNEY OF UNFIT PATIENTS WITH NEWLY DIAGNOSED IDH1M ACUTE MYELOID LEUKEMIA
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: October 31, 2026
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The management of acute myeloid leukemia (AML) in elderly or unfit patients has undergone a paradigm shift with the integration of molecular diagnostics and targeted therapies. Among actionable alterations, IDH1 mutations define a biologically distinct subgroup for which ivosidenib combined with azacitidine has recently emerged as a standard of care.
However, initial clinical management remains complex. Three main themes emerged from the expert panel’s discussion: all patients should be tested for IDH1m, with turnaround time of 3-5 days; adequate patient monitoring during treatment is essential to detect the earliest signs of differentiation syndrome and QTc prolongation; appropriate management of concomitant therapies is required, not only for azole derivatives administered for antifungal prophylaxis, where need.
This paper provides a comprehensive and evidence-based framework for optimizing early management in unfit patients with newly diagnosed IDH1-mutated AML, integrating data from randomized trials, real-world studies, and updated evidence on antifungal prophylaxis and drug–drug interactions in the era of targeted therapies.
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Ethics Approval
Acute myeloid leukemia; Clinical Journey; Unfit Patients; Newly Diagnosed; IDH1m , Ethical Approval not applicableSupporting Agencies
Medical writing support (editing) was funded by Servier Italia S.p.A., in accordance with Good Publication Practice (GPP,2022) guidelines. The funder was not involved in the paper design, collection, analysis, interpretation of data , the writing of this article or the decision to submit it for publication.How to Cite
“OPTIMIZATION OF THE CLINICAL JOURNEY OF UNFIT PATIENTS WITH NEWLY DIAGNOSED IDH1M ACUTE MYELOID LEUKEMIA” (2026) Mediterranean Journal of Hematology and Infectious Diseases, 18(1), p. e2026086. doi:10.4084/MJHID.2026.086.
Copyright (c) 2026 Adriano Venditti, Marta Riva, Livio Pagano, Giovanni Marconi, Nicola Fracchiolla, Romano Danesi, Antonio Curti, Anna Candoni, Erika Borlenghi, Maria Teresa Voso
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
