What are the current guidelines for the management of newly diagnosed AML in adults, including any recommended treatment pathways?

The management of newly diagnosed acute myeloid leukemia (AML) in adults in the UK is guided by national recommendations, emphasizing a multidisciplinary approach and rapid access to specialist care NICE NG47.

Diagnosis and Initial Management:

• Patients with suspected haematological cancers, including AML, should be referred to a specialist multidisciplinary team (MDT) for diagnosis and management NICE NG47.
• Rapid diagnosis is crucial, and the MDT should ensure timely access to diagnostic tests and specialist opinions NICE NG47.
• The MDT is responsible for developing an individualized treatment plan based on the patient's specific AML subtype, risk stratification, and overall health NICE NG47.

Treatment Pathways:

• For most newly diagnosed adult AML patients, treatment typically involves intensive chemotherapy regimens aimed at achieving remission NICE NG47.
• However, specific subtypes of AML have distinct treatment pathways. For instance, acute promyelocytic leukemia (APL), a subtype of AML, has unique treatment strategies that often involve all-trans retinoic acid (ATRA) in combination with chemotherapy or arsenic trioxide, leading to high cure rates Sirulnik & Stone 2005.
• Treatment strategies for adolescent and young adult (AYA) patients with AML may differ from those for older adults, often involving more intensive regimens or consideration of clinical trials tailored to this age group O'Dwyer et al. 2018.
• Decisions regarding treatment intensity, stem cell transplantation, and supportive care are made by the specialist MDT, considering the patient's fitness and disease characteristics NICE NG47.