Why is it important for a patient to receive care from an AML expert instead of a general oncologist?

Why is it important for a patient to receive care from an AML expert instead of a general oncologist? Acute myeloid leukemia is a very complicated disease and it is definitely not one disease that affects everybody. Each patient's disease has a different signature. There are several chromosomal or cytogenetic abnormalities that are present and there are several mutations that can be present in a particular patient's leukemia and they're different. There could be 500 genes that are known to be mutated in leukemia and every patient can have a mix of two or three of these, one, two. It's just so diverse that treatment has to be thought about specific for that patient. It is not like every leukemia patient is treated the same way. I would say the opposite. Every leukemia patient is treated based on their signature of leukemia. There are decisions to be made as to whether one chemotherapy is better than the other in the upfront setting, whether the decision to transplant is based on some of these molecular signatures that the leukemia might have and also with the ongoing newer treatments that are available and increasingly becoming available. The best way to combine these medications to improve cure rates of leukemia and also not give excess toxicity, this is a lot of information to actually digest and incorporate into your practice. The doctors who are AML experts live and breathe this all the time. They are doing the newest clinical trials on this. The access to clinical trials are through an AML expert usually. It's something that is important for patients. It is such a specialized field. Each and every decision making at several time points is taken into consideration based on shifting information, ability to respond, how much disease is left behind at the end of it. This is complicated. It's always a good idea to have an AML expert on board or get treated under an AML expert. Also don't forget that a lot of patients with leukemia are going to get transplanted. It's always better to actually start your treatment anyways in a center that has AML expertise because then you can have one team that seamlessly follows plans and discusses among themselves which patients to transplant, why, what is the best timing for transplant. This is a lot of work which is difficult when you're shuffling back with a general oncologist, going back to the transplant doctor. More and more as we treat leukemia, we try to achieve what we call an MRD or minimal residual disease eradication. So treatments are designed and monitored and changed depending on MRD status. The goal is to get into an MRD negative remission. That means using sophisticated technologies to say there is no leukemia left behind below a particular level that we care about. To reach that goal, you have to constantly monitor the patient, think about treatment options that lead you to that state and to the decision of when to transplant, when is a patient's bone marrow at optimal timing to transplant. These are very complicated decisions and it takes hours of thinking and going through all of that for just one patient which is difficult to gather all of that and get everything at a local practice or a community center. And the biggest thing is clinical trials. I strongly believe that every patient should be treated on a clinical trial if they are eligible. That is where newer drugs are being incorporated. We have a better chance of curing patients on clinical trials. I highly encourage to get at least an opinion from any AML expert.