Optimizing the allo-HSCT pathway for AML in the UK: A Delphi consensus study

Results from a modified Delphi consensus study evaluating strategies to improve allogeneic hematopoietic stem cell transplantation (allo-HSCT) accessibility for adult patients with acute myeloid leukemia (AML) in the UK were published in eJHaem by Mehta et al. The aim of this study was to provide recommendations for streamlining and optimizing care and allo-HSCT pathways for patients with AML.

Key data: Consensus (≥75% agreement) was achieved across all 47 statements, with only four reaching <90% agreement. Nine key recommendations were developed based on the consensus-agreed statements: early transplantation discussions with patients at diagnosis; comprehensive assessment of patient eligibility for transplantation; consideration of transplantation for patients aged >60 years; integration of genetic and cytogenetic findings into patient case review; involvement of a regional multidisciplinary team (MDT); optimizing timing of transplantation (ideally in first complete remission [CR1], or in CR2 if not feasible in CR1); ensuring documentation and accountability when delays occur; post-transplantation planning; and standardization of communication protocols between referring hospitals, transplantation centers, and patients, to improve allo-HSCT accessibility across the UK.

Key learning: Strong expert consensus was achieved across statements, supporting the development of actionable recommendations to minimize delays to transplantation, strengthen communication between the MDT and patients, and optimize care pathways and accessibility for transplant-eligible patients with AML.