What is acute promyelocytic leukemia (APL)?

Updated: Jul 02, 2019
  • Author: Sandy D Kotiah, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Acute promyelocytic leukemia (APL) is a distinct variant of acute myeloid leukemia (AML). It is classified as AML M3 by the old French-American-British (FAB) system and as APL with translocation between chromosomes 15 and 17—that is, t(15;17)—by the World Health Organization (WHO) classification system.

Although rapid confirmation of genetic diagnosis is mandatory, patients in whom APL is suspected (on the basis of clinical presentation and peripheral blood smear results) should be immediately hospitalized and their case managed as a medical emergency. [1]  

Patients with APL may be stratified into the following 3 risk categories on the basis of white blood cell (WBC) count and platelet count.:

  • Low risk - WBC count < 10,000/µL and platelet count > 40,000/µL
  • Intermediate risk - WBC count < 10,000/µL and platelet count < 40,000/µL\
  • High risk -  WBC count > 10,000/µL

Treatment of APL includes induction therapy, consolidation therapy, and maintenance therapy. Protocols for these stages are provided below, as well as recommendations for management of relapse and for prophylaxis.

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