Optimal timeframes & summary

Evidence-based guidelines, where they exist, should inform timeframes. Treatment teams need to recognise that shorter timeframes for appropriate consultations and treatment can promote a better experience for patients. Three steps in the pathway specify timeframes for care. They are designed to help patients understand the timeframes in which they can expect to be assessed and treated, and to help health services plan care delivery in accordance with expert-informed time parameters to meet the expectation of patients. These timeframes are based on expert advice from the Acute Myeloid Leukaemia Working Group.

Timeframes for care

Step in pathway

Care point


Presentation, initial investigations and referral

Signs and symptoms

Presenting symptoms should be promptly and clinically triaged with a health professional

Initial investigations initiated by GP

The GP should begin investigations immediately if AML is suspected

Laboratory results should be actively followed up and progressed on the same day

Referral for emergency assessment/ Initial referral

Patients with sepsis, bleeding or severe symptoms should be regarded as a medical emergency and be referred immediately to an appropriate emergency facility without necessarily waiting for results of laboratory tests (same day)

Patients with a laboratory diagnosis of possible AML should be referred for an urgent assessment by a haematologist at an appropriate facility within 24 hours (unless advised otherwise by a haematologist)

Diagnosis, staging and treatment planning

Diagnosis and staging

Morphological assessment to identify APL should be conducted immediately and the result conveyed to the treating physician as soon as possible

For all patients with AML, other results necessary for immediate management decisions should be available within 72 hours of the patient presenting

Multidisciplinary meeting and treatment planning

Immediate treatment is often required before a full MDM ratifies the management plan details. Multidisciplinary input is likely to be required at several points after the first treatment begins


Systemic therapy

Induction therapy should start promptly once a diagnosis is made and a treatment plan for intensive chemotherapy is confirmed

Consolidation therapy should start within 6 weeks of induction chemotherapy beginning

Allogenic stem cell transplant

Donor searches should begin for all anticipated allogeneic stem cell transplant (allo-SCT) canditates in first remission (CR1) patients as soon as their risk status is known

Radiation therapy

Radiation therapy may be used for symptom control in palliation and occasionally for treatment

Seven steps of the optimal care pathway

Step 1: Prevention and early detection

Step 2: Presentation, initial investigations and referral

Step 3: Diagnosis, staging and treatment planning

Step 4: Treatment

Step 5: Care after initial treatment and recovery

Step 6: Managing relapsed or refractory disease

Step 7: End-of-life care

This pathway covers acute myeloid leukaemia (AML) in adults, including acute promyelocytic leukaemia (APL). AML is the most common form of acute leukaemia in adults (NCCN 2019). The yearly incidence rate of AML in Australian adults is 3.9 cases per 100,000, with a five-year survival rate of 28 per cent (AIHW 2019).