Text on Screen: Sponsored by AbbVie. Healthcare Providers were compensated for their time.
Dr. Shah: I love doing these sit downs, mainly because I'm a patient advocate. The more we express the benefits of this collaboration, we hopefully will inspire other physicians to do the same.
Text on Screen:
Ashish Shah, DO
Advanced Care Oncology and Hematology Associates
Atlantic Medical Group
Community Provider
James K. McCloskey, II, MD
Chief, Leukemia Division, John Theurer Cancer Center
Hackensack University Medical Center
Academic Provider
Dr. McCloskey: I just saw one of your patients yesterday.
We have built a system of collaboration that has been incredibly rewarding.
Dr. Shah: Are you ready to do this?
Dr. McCloskey: Yeah. I'm excited.
Text on Screen: COLLABORATION IN AML
Dr. McCloskey: When it comes to AML in a community setting, what are some of the challenges as you approach treating these patients?
Text on Screen: The challenges of treating and managing AML
Dr. Shah: These patients have a narrow window where we can achieve the best outcome, right? It's almost as if you have to treat these patients with white gloves and care, because anything can go wrong at any moment.
What about you? What challenges do you guys have?
Dr. McCloskey: I think sometimes it's navigating these challenging treatment decisions at such a time of crisis. Sometimes it's trying to treat the disease when dealing with the complications of the disease itself.
Dr. Shah: Yeah. And with all these complexities, community oncology care doesn't have the infrastructure to support how sick these patients are, like needing same day transfusions. A lot of times the default is to send these patients to the emergency room. And it's very difficult managing these toxicities because they can come on, so all of a sudden. One minute the patient has stable blood counts, literally the next day they have to be rushed to the hospital for transfusions, or they have a life-threatening infection.
So, these kind of crises can really, you know, put a lot of stress on our oncology team, but also the patient and their family.
Dr. McCloskey: Yeah. Yeah. It could be very difficult.
Dr. Shah: You know, you and I have been working together for over ten years now.
Text on Screen: The goal: Seamless communication between the community oncologist and AML specialist
Dr. Shah: From the community side, it feels very seamless being able to communicate and just share thoughts. What do you think I should do here? You know, this is the patient's situation.
Dr. McCloskey: It's really great when we get to meet the patient. When they're first diagnosed or after that first round of treatment. It allows us to review their treatment plan, evaluate them early rather than later. So that down the line, if they need us I have that relationship with them. But if otherwise they're doing well, then they can stay with their local provider.
Dr. Shah: One of the most compelling parts of a collaboration with an academic center is being able to manage these side effects, especially when the patient goes into crisis.
Text on Screen: Partnerships can help provide patients the level of care they need, when they need it
Dr. Shah: You don't have much time, and that's usually when the patient is developing side effects not only from their disease, but from possibly treatment. The patients who have been the most difficult, their care was optimized because they were able to go back and forth.
And when there was a crisis, we got them directly to where they needed to be to get the type of treatment that I likely would not have been able to provide for them, at least not in that time frame.
Dr. McCloskey: That can be really transformative for people who are sick.
Text on Screen: Collaboration at all stages across the care team may lead to transformative care for patients
Dr. McCloskey: Sometimes we're even collaborating on those nitty gritty things about when they're getting their labs with you next and what I'm seeing here and what I think needs to happen there.
Dr. Shah: Being able to collaborate allows for this back-and-forth flow, not just of information, but of insight, and a lot of the logistics of setting up their care and also pivoting or transitioning.
Ultimately, there are a limited number of treatment courses that are available, and it's very important to sequence them as effectively and efficiently as possible.
Text on Screen: The process: Sharing nuances about treatment planning based on clinical experience at a tertiary center
Dr. Shah: And I think because of our collaboration, we're offering these patients probably more options than they would have had.
Dr. McCloskey: Particularly in a community setting, there's a real benefit to the clinical experience that one develops at a tertiary center. There's often nuances about dosing a drug or planning a treatment that's really hard to capture in a guideline or prescribing document. We would even share protocols, so you could see how we made it work in our practice.
And I think that improves that patient's overall clinical outcome.
Dr. Shah: I can't agree more. Being able to share information and just share clinical pearls has made my care in the community much more optimal for these patients' outcomes.
Dr. McCloskey: You mentioned transfusions. We're really lucky that we have an extensive blood bank. And I know that's not possible everywhere. Some patients come back here for their next bone marrow biopsy. I know you do your own marrows, but some practices don't prefer to do them.
Dr. Shah: And I like the fact that sometimes I can offer them additional tests that you can do off of your bone marrow that we may not be able to offer in our practice, which is very helpful to determine the trajectory of their therapy.
Dr. McCloskey: I do hear a lot from providers, sometimes they have a relationship they value with their patient.
Dr. Shah: Absolutely.
Dr. McCloskey: They want that patient to come back to them. And I always sort of say, I'm happy for that patient to go back to their preferred provider.
Text on Screen: The task: Clarifying the treatment plan and the distinct roles of the care team
Dr. McCloskey: It is just really important that we're clear about what happened under my care, and together, what is our plan moving forward. So, let's try to plan as a unit.
Text on Screen: Collaboration supports proactive treatment and management
Dr. McCloskey: Proactivity is so important.
Dr. Shah: You know, and I think in the community especially with AML patients, it's so important to be proactive with their treatment and management.
Dr. McCloskey: We won't make progress unless we work together, and I think our patients feel that.
Text on Screen: NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Acute Myeloid Leukemia1*
*See NCCN Guidelines for AML, Version 3.2026, for complete recommendations and principles. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.
Dr. McCloskey: And, you know, the NCCN agrees with us that this collaboration is valuable. Working together can ensure that patients get the appropriate workup initially, but also help improve their safety when we plan their actual treatment.
Dr. Shah: Yeah, and at the end of the day, from a community standpoint, it's crucial we feel the trust with the academic centers. And I think that's really the only way you can build the foundation of a collaboration.
Text on Screen: Collaboration between community oncologists and AML specialists can lead to optimal patient care
Dr. Shah: Knowing that these patients receive the ultimate optimal care for their AML, whether it be at your institution, or at my institution, or at both. If it was my family member who had AML, this is the way I want them to be treated by you and by me.
Dr. McCloskey: The model we've built has really just been so tremendously successful that it seems inappropriate not to share it, because I think it can only help other providers and patients.
Dr. Shah: Great job.
Dr. McCloskey: Great job. You too.
Dr. Shah: All of my patients feel like they're VIPs at this point, you know, because they have two people taking care of them.
Dr. McCloskey: Patients really benefit from getting care close to home still.
And, you know, that's what we have in this collaboration.
Reference: 1. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Acute Myeloid Leukemia V.3.2026. © National Comprehensive Cancer Network, Inc. 2025. All rights reserved. Accessed November 24, 2025. To view the most recent and complete version of the guideline, go online to NCCN.org.
US-ONCA-250008