Acute Promyelocytic Leukemia

Condition 101

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 ...

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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 for 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.

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.

Latest Research

Latest Advance
  • Condition: Acute Promyelocytic Leukemia
  • Journal: Cancer
  • Treatment Used: Oral Arsenic Trioxide, All-Trans Retinoic Acid, and Ascorbic Acid (AAA)
  • Number of Patients: 129
  • Published —
This study tested the safety and efficacy of using an AAA formulation to treat patients with acute promyelocytic leukemia.
Latest Advance
  • Condition: Neoplastic diseases
  • Journal: Metallomics : integrated biometal science
  • Treatment Used: Arsenic trioxide
  • Number of Patients: 0
  • Published —
The study researched the potential uses of arsenic trioxide for various cancers and neoplastic diseases.
Latest Advance
  • Condition: Acute Promyelocytic Leukemia (APL)
  • Journal: Cancer medicine
  • Treatment Used: Bortezomib
  • Number of Patients: 22
  • Published —
This study evaluated the role of bortezomib in the management of relapsed acute promyelocytic leukemia (a cancer of the white blood cells; APL) after arsenic trioxide (ATO) therapy.
Latest Advance
  • Condition: Relapsed Acute Promyelocytic Leukemia Patients
  • Journal: Zhongguo shi yan xue ye xue za zhi
  • Treatment Used: Arsenic Trioxide with ATRA and Chemotherapy
  • Number of Patients: 25
  • Published —
The study researched the effects of arsenic trioxide with ATRA (vitamin A derivative) and chemotherapy for patients with relapsed acute promyelocytic leukemia patients.

Clinical Trials

Clinical Trial
  • Status: Recruiting
  • Participants: 1000
  • Start Date: February 2, 2020
The Acute Promyelocytic Leukaemia Asian Consortium (APL-AC) Project
Clinical Trial
  • Status: Recruiting
  • Study Type: Drug
  • Participants: 100
  • Start Date: June 1, 2019
A Prospective Single Center Study of Prevention and Treatment of Differentiation Syndrome in Patients With Acute Promyelocytic Leukemia
Clinical Trial
  • Status: Recruiting
  • Study Type: Drug
  • Participants: 60
  • Start Date: August 15, 2018
Risk-stratified Frontline Oral Arsenic Trioxide-based Induction in Newly Diagnosed Acute Promyelocytic Leukaemia