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Elderly patients with acute myeloid leukemia (AML) have poor outcomes with standard intensive chemotherapy and are managed with supportive care, low-dose chemotherapy, or hospice care. In this Editorial, the topic is reviewed, and the author discusses the article in this issue of Cancer by Burnett et al concerning the use of low-dose cytarabine versus hydroxyurea in patients with AML who are considered unfit to receive intensive chemotherapy.