【Abstract】The major factors contributed to poor prognosis in elderly AML. The proportion of secondary to myelodysplastic syndromes (MDS) was significantly higher than that of young people. The chromosomal karyotype and gene mutations associated with poor prognosis are more common. Accompanied with many underlying diseases leaded to poor tolerance to chemotherapy. Therefore, before the treatment of elderly patients with AML is identified，It is necessary to evaluate the patient's tolerance to chemotherapy carefully. While those who unfit for curative chemotherapy, palliative treatment or best supporting care were recommended，the other elderly patients who fit for chemotherapy should accept combined chemotherapy with decitabine or decitabine, it can obviously improve patient tolerance, prolong survival and improve prognosis. For elderly patients with AML who are able to tolerate a reduced dose of AlloHSCT, a greater benefit can be obtained by the choice of transplant therapy. However, obtaining CR before transplantation, especially CRMRD before transplantation, is the key to improve the longterm survivor after transplantation. A number of studies have demonstrated that the reasonable application of decitabine, before, during and after transplantation, can improve the rate of CR before transplantation, improve the efficacy of transplantation, prevent recurrence and severe GVHD, especially the occurrence of cGVHD, after transplantation.