Acute promyelocytic leukemia
(Redirected from Acute promyelocytic leukaemia)
Acute Promyelocytic Leukemia
Acute Promyelocytic Leukemia (APL) is a subtype of acute myeloid leukemia (AML), characterized by the accumulation of promyelocytes in the bone marrow. It is classified as AML-M3 in the French-American-British (FAB) classification system.
Pathophysiology[edit | edit source]
APL is caused by a specific chromosomal translocation, t(15;17)(q24;q21), which results in the fusion of the promyelocytic leukemia (PML) gene on chromosome 15 and the retinoic acid receptor alpha (RARA) gene on chromosome 17. This PML-RARA fusion protein interferes with normal hematopoiesis and leads to the accumulation of promyelocytes.
Clinical Presentation[edit | edit source]
Patients with APL often present with symptoms related to cytopenias and coagulopathy. Common symptoms include:
- Fatigue and weakness due to anemia
- Infections due to neutropenia
- Bleeding and bruising due to thrombocytopenia and disseminated intravascular coagulation (DIC)
Diagnosis[edit | edit source]
The diagnosis of APL is confirmed through:
- Complete blood count (CBC) showing cytopenias
- Bone marrow biopsy revealing promyelocytes
- Cytogenetic analysis to detect the t(15;17) translocation
- Molecular testing for the PML-RARA fusion gene
Treatment[edit | edit source]
The treatment of APL has been revolutionized by the introduction of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). The standard treatment regimen includes:
- Induction therapy with ATRA and ATO
- Consolidation therapy to eliminate residual disease
- Maintenance therapy to prevent relapse
Prognosis[edit | edit source]
The prognosis for patients with APL has improved significantly with modern treatment protocols. The 5-year survival rate is over 80% with appropriate therapy. Early diagnosis and treatment are crucial to prevent complications such as DIC.
Complications[edit | edit source]
Complications of APL include:
See Also[edit | edit source]
External Links[edit | edit source]
- [American Cancer Society: Acute Promyelocytic Leukemia]
- [Leukemia & Lymphoma Society: APL]
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Contributors: Kondreddy Naveen, Prab R. Tumpati, MD
