A Delphi Consensus on Optimising the Care Pathway for Adult Patients With Acute Myeloid Leukaemia (AML): Strategies to Enhance Transplant Accessibility and Feasibility in the United Kingdom.

Background: Allogeneic haematopoietic stem cell transplant (allo-HSCT) is a curative option for a large proportion of acute myeloid leukaemia (AML) patients, but availability remains challenging and transplantation is underutilised in the United Kingdom. This consensus aimed to define an optimal UK care pathway for AML and develop recommendations to improve transplant accessibility. Methods: A steering group of six clinicians, experienced in AML management and stem cell transplantation, designed 47 consensus statements around the optimal UK transplant pathway. These were distributed as a survey to a broader group of clinicians involved in AML management. The threshold for consensus was set at 75% agreement. Results: A total of 75 responses were received, including 60 haematologists and 15 transplant specialists. All statements reached consensus. Results emphasise the need to involve transplant centres promptly, initiate donor searches early, properly document treatment decisions, and define communication protocols between centres and patients. The findings informed a set of recommendations for care and a clinical checklist. Conclusion: There is clear willingness to shift the AML treatment paradigm and improve accessibility of allo-HSCT. The proposed recommendations focus on improving time to transplant, patient assessment and communication protocols. Alongside the checklist, they offer a practical framework to improve services. Trial Registration: The authors have confirmed clinical trial registration is not needed for this submission.