治疗相关的髓系肿瘤(t-MNs)是指在治疗非相关疾病时接触放射线/细胞毒性药物后出现的一种特定的髓系恶性肿瘤亚组。这种恶性肿瘤呈现出独特的特征，包括高龄、严重并发症负担和不利的基因特性。所有这些特征都证明了特定的诊断工作和专用治疗算法的必要性。然而，由于新的分类系统意识到t-MN患者所表现的独特临床特征，如何评估其适应能力在临床设置中尚未得到充分探索。优化适应能力评估对于t-MN患者的管理至关重要，考虑到通常影响疗效的因素(如年龄、并发症和治疗史)是针对每个患者的。在缺乏特定的适应能力评估工具的情况下，本综述旨在描述与患者、治疗和疾病相关的所有因素，以便制定具有最佳风险/效益比的治疗方案。

Therapy-related myeloid neoplasms (t-MNs) encompass a specific sub-group of myeloid malignancies arising after exposure to radio/cytotoxic agents for the treatment of unrelated diseases. Such malignancies present unique features, including advanced age, high comorbidities burden, and unfavorable genetic profiles. All these features justify the need for a specific diagnostic work-up and dedicated treatment algorithms. However, as new classification systems recognize the unique clinical characteristics exhibited by t-MN patients, how to assess fitness status in this clinical setting is largely unexplored. Optimizing fitness assessment would be crucial in the management of t-MN patients, considering that factors usually contributing to a worse or better outcome (like age, comorbidities, and treatment history) are patient-specific. In the absence of specific tools for fitness assessment in this peculiar category of AML, the aim of this review is to describe all those factors related to patient, treatment, and disease that allow planning treatments with an optimal risk/benefit ratio.