靶向分子和免疫治疗的引入正在改变急性髓性白血病（AML）的治疗格局。我们总结了可以用于治疗老年AML患者的生物疗法。除了针对特定基因突变的小分子抑制剂外，还正在开发针对疾病治愈的抗体、肿瘤微环境调节剂和细胞治疗。在这里，我们报告针对表面抗原如CD33（杂交素脂质体）或CD123（孙立人抗体）的人源抗体和抗体药物共轭物的生物活性、疗效和毒性。我们进一步探讨了修改微环境的药物如格拉司吉布，或利用免疫系统对抗白血病的药物如CD47抗体马格罗利马布、PD1/PDL1抑制剂帕博利珠单抗和尼伏单抗、TIM3抑制剂萨巴托利马布、T细胞和NK细胞受体。虽然细胞治疗仍有一项大型试验待进行，但我们仍在考虑采用该方法。在这种情况下，我们提供了目标药物作用机理的简要概述，特别是针对其生物机制方面。总的来说，这种治疗手段将构成基础，为多模式和个性化组合提供基础，在精准医学的理念下，将极大地惠及老年AML患者。

The introduction of target molecules and immunological therapies is changing the treatment landscape of acute myeloid leukemia (AML).We recapitulate the biological therapies that can be employed in the treatment of elderly patients with AML. Alongside small molecules inhibitors that target specific gene mutations, antibodies, tumor microenvironment modulators, and cellular therapies are being developed for the cure of the disease. Here, we report the biological activities, the efficacy and toxicities of humanized antibodies and antibody-drug conjugates that targets surface antigens as CD33 (gemtuzumab ozogamicine) or CD123 (pivekimab sunirine). We further explore mechanisms and effectiveness of medications that modify the microenvironment, such as glasdegib, or that harness the immune system against leukemia, such as CD47 antibody magrolimab, PD1/PDL1 inhibitors pembrolizumab and nivolumab, TIM3 inhibitor sabatolimab, T-cell and NK-cell engagers. Cellular therapies are considered, even if a large trial is still pending for the feasibility of the approach. In this scenario, a brief overview of the mechanism of action of target agents is provided, particularly with respect to their biological mechanisms.Overall, this therapeutic armamentarium will constitute the basis for multimodal and personalized combinations that, in the idea of precision medicine, will enormously benefit elderly AML patients.