Poor cardiopulmonary reserve, undernutrition, frailty or poor physical performance status (assessed by, eg, Karnofsky performance status [KPS] or Eastern Cooperative Oncology Group performance status [ECOGPS]), comorbidities, including cytopenias, and psychiatric or cognitive illness all may lead to a decision for palliative over curative treatment or for no treatment at all, even though a cure with aggressive therapy might technically be possible.