Learn About Acute Promyelocytic Leukemia

What is the definition of Acute Promyelocytic Leukemia?
Acute promyelocytic leukemia (APL) is an aggressive type of acute myeloid leukemia in which there are too many immature blood-forming cells (promyelocytes) in the blood and bone marrow. This build up of promyelocytes leads to a shortage of normal white and red blood cells and platelets in the body. The signs and symptoms of APL include an increased risk to both bleed and form blood clots. Individuals may also experience excessive tiredness, pain in affected areas, loss of appetite, and weight loss. APL usually occurs in middle-aged adults, but can be diagnosed at any age. It is caused by a mutation that is acquired over a person's lifetime, usually involving a translocation between chromosomes 15 and 17. Treatment may include the use of all-trans retinoic acid (ATRA) and arsenic trioxide or anthracycline-based chemotherapy.
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What are the alternative names for Acute Promyelocytic Leukemia?
  • Acute myeloblastic leukemia type 3
  • Acute myeloid leukemia with t(15;17)(q22;q12);(PML/RARalpha) and variants
  • AML M3
  • AML with t(15;17)(q22;q12);(PML/RARalpha) and variants
  • Acute myeloblastic leukemia 3
  • APML
What are the causes of Acute Promyelocytic Leukemia?
APL is caused by a chromosomal translocation (rearrangement of material) that occurs in some of the body's cells during a person's lifetime (a somatic mutation). The translocation involves the fusion of two genes: the PML gene on chromosome 15 and the RARA gene on chromosome 17. The protein produced by this fusion is referred to as PML-RARα. The PML-RARα protein functions differently than what is typically produced by the normal PML and RARA genes. As a result of the abnormal function, blood cells become "stuck" at the promyelocyte stage and they proliferate (reproduce) abnormally. Excess promyelocytes then accumulate in the bone marrow, disrupting the formation of normal white blood cells and leading to APL. Translocations involving the RARA gene and other genes have been identified in only a few cases of APL.
What are the current treatments for Acute Promyelocytic Leukemia?
Most cases of APL are treated with an anthracycline chemotherapy drug (daunorubicin or idarubicin) plus the non-chemotherapy drug, all-trans-retinoic acid (ATRA), which is a relative of vitamin A. This treatment leads to remission in 80% to 90% of patients. Patients who cannot tolerate an anthracycline drug may get ATRA plus another drug called arsenic trioxide. Arsenic trioxide has also proven to be an effective alternative for the 20% to 30% of patients with APL who don't respond to initial treatment or who relapse. If treatment with arsenic trioxide achieves a remission, further courses of this drug may be given. A stem cell transplant may also be an option. If a second remission is not achieved, treatment options may include a stem cell transplant or taking part in a clinical trial. Additional information related to treatment of acute promyelocytic leukemia can be accessed through Medscape. This includes detailed information related to the use of arsenic trioxide.
Who are the top Acute Promyelocytic Leukemia Local Doctors?
Elite
Highly rated in
32
conditions
Oncology
Hematology Oncology
Hematology

University Of Texas MD Anderson Cancer Center

Houston, TX 

Tapan Kadia is an Oncologist and a Hematologist Oncology doctor in Houston, Texas. Dr. Kadia has been practicing medicine for over 21 years and is rated as an Elite doctor by MediFind in the treatment of Acute Promyelocytic Leukemia. He is also highly rated in 32 other conditions, according to our data. His top areas of expertise are Acute Myeloid Leukemia, Myelodysplastic Syndrome, Leukemia, and Acute Lymphoblastic Leukemia. He is board certified in Internal Medicine, Hematology, and Medical Oncology and licensed to treat patients in Texas. Dr. Kadia is currently accepting new patients.

Elite
Highly rated in
14
conditions

Hospital Universitari I Politècnic La Fe

Valencia, VC, ES 

Miguel Sanz is in Valencia, Spain. Sanz is rated as an Elite expert by MediFind in the treatment of Acute Promyelocytic Leukemia. He is also highly rated in 14 other conditions, according to our data. His top areas of expertise are Acute Promyelocytic Leukemia, Acute Myeloid Leukemia, Leukemia, and Acute Myeloblastic Leukemia with Maturation.

 
 
 
 
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Elite
Highly rated in
8
conditions

University Of Tor Vergata

Rome, IT 

Francesco Coco-Lo is in Rome, Italy. Coco-Lo is rated as an Elite expert by MediFind in the treatment of Acute Promyelocytic Leukemia. He is also highly rated in 8 other conditions, according to our data. His top areas of expertise are Acute Promyelocytic Leukemia, Acute Myeloid Leukemia, Leukemia, and Acute Myeloblastic Leukemia without Maturation.

Is Acute Promyelocytic Leukemia an inherited disorder?
APL is not inherited. The condition arises from a translocation in some of the body's cells (somatic cells) that occurs after conception. This is referred to as a somatic mutation. Somatic mutations may affect the individual by causing cancers or other diseases, but they are not passed on to offspring.
What are the latest Acute Promyelocytic Leukemia Clinical Trials?
A Phase II Study Incorporating Sorafenib (NSC 724772) Into the Therapy of Patients >/= 60 Years of Age With FLT3 Mutated Acute Myeloid Leukemia
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Ipilimumab and All-Trans Retinoic Acid Combination Treatment of Advanced Melanoma
What are the Latest Advances for Acute Promyelocytic Leukemia?
Acute Promyelocytic Leukemia: Update on Risk Stratification and Treatment Practices.
Long-term quality of life of patients with acute promyelocytic leukemia treated with arsenic trioxide vs chemotherapy.
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Unrelated cord blood stem cell transplantation for high-risk/refractory childhood acute myeloid leukemia: a clinical analysis of 160 cases.