Table of ContentsView AllTable of ContentsGeneticsPromyelocytesSymptomsTreatmentPrognosisCoping/Support
Table of ContentsView All
View All
Table of Contents
Genetics
Promyelocytes
Symptoms
Treatment
Prognosis
Coping/Support
Acute promyelocytic leukemia (APL) is a subtype of acute myelogenous leukemia (AML), a cancer of the blood. You may also hear it referred to as M3 AML. In the United States, APL accounts for about 10-15% of all AML cases.megaflopp / iStockphotoWhile it is similar in many ways to the other subtypes, APL is distinctive and has a specific treatment regime. Treatment outcomes for APL are very good, and it is considered themost curable type of leukemia, with cure rates as high as 90%.Genetics and Acute Promyelocytic Leukemia (APL)The genetic abnormality most often seen in the DNA of the leukemia cells is a translocation between chromosomes 15 and 17.This means that a part of chromosome 15 breaks off, and is exchanged with a part of chromosome 17.This mutation leads to the production of a protein that causes blood cell development to get “stuck” at the promyelocytic stage when white blood cells are young and immature.What Are Promyelocytes?Promyelocytes are intermediate cells in the white blood cell maturation process, with the “babies"being myeloblasts or blasts, and the adults being the myelocytes known asneutrophils, eosinophils,basophils, andmonocytes.Promyelocytic leukemia cells can be compared to human teenagers. They look a bit like adults, but they can’t get jobs, pay the bills, drive a car, or do the daily functions of fully mature humans. Likewise, promyelocytic blood cells are too underdeveloped to perform the roles of fully mature white blood cells in the body.Signs and SymptomsPeople with APL have many of the same symptoms as other types of AML. Most of the signs of leukemia are the result of cancer cells “crowding out” thebone marrowand interfering with the production of normal, healthy red blood cells, white blood cells, and platelets.These signs and symptoms include:Having low energy, or feeling tired all the timeFeeling short of breath when doing regular activitiesPale skinUnexplained feversDelayed healing from cuts and bruisesAchy bones or jointsDifficulty fighting off infectionsIn addition to these signs of AML, people with APL also have other characteristic symptoms.They will often have:Severe bleeding problems such as bruising, nosebleeds, blood in the urine or bowel movementsAbnormal, excessive clotting of the bloodGirls and women with APL may notice unusually heavy menstrual periods.The symptoms of leukemia can be vague, and may also occur with other, non-cancerous conditions. If you are concerned about your health, or the health of a loved one, it is always best to seek the advice of a medical professional.TreatmentThe treatment of APL is verydifferent than that of other types of acute leukemia, so properly identifying it is critical.Most people with APL are treatedinitially with a combination of all-trans retinoic acid (ATRA), a specialized form of vitamin A and with arsenic trioxide (ATO). ATRA therapy is unique in that it forces the promyelocytic leukemia cells to mature, a bit like how graduating college forces the teenagers in our comparison into the adult role (well, at least sometimes). This phase of treatment is referred to as “induction.“For many people, the combination of ATRA and ATO is curative. For some people,chemotherapytreatment is used as well.After initial treatment, ATRA is often continued for at least a year, sometimes combined with other medications. This last phase of treatment is called “maintenance.“PrognosisTreatment of APL is successful in the vast majority of cases.Coping and SupportEven though APL has an excellent prognosis, the diagnosis and treatment process can be exhausting for you. Make sure you give yourself time to rest. Consider reaching out to family and friends—and accept their help.Take time to learn about survivorship andcoping. When cancer treatment ends, instead of elation, many people feel depressed. Persistent side effects of treatment and time spent on the emotional roller coaster of cancer can leave you wondering if you will ever feel normal again. There are resources to help cancer survivors thrive. Studies actually tell us that cancer changes people in good ways, not just bad.Leukemia Doctor Discussion GuideGet our printable guide for your next doctor’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Acute promyelocytic leukemia (APL) is a subtype of acute myelogenous leukemia (AML), a cancer of the blood. You may also hear it referred to as M3 AML. In the United States, APL accounts for about 10-15% of all AML cases.
megaflopp / iStockphoto
While it is similar in many ways to the other subtypes, APL is distinctive and has a specific treatment regime. Treatment outcomes for APL are very good, and it is considered themost curable type of leukemia, with cure rates as high as 90%.
Genetics and Acute Promyelocytic Leukemia (APL)
The genetic abnormality most often seen in the DNA of the leukemia cells is a translocation between chromosomes 15 and 17.This means that a part of chromosome 15 breaks off, and is exchanged with a part of chromosome 17.
This mutation leads to the production of a protein that causes blood cell development to get “stuck” at the promyelocytic stage when white blood cells are young and immature.
What Are Promyelocytes?
Promyelocytes are intermediate cells in the white blood cell maturation process, with the “babies"being myeloblasts or blasts, and the adults being the myelocytes known asneutrophils, eosinophils,basophils, andmonocytes.
Promyelocytic leukemia cells can be compared to human teenagers. They look a bit like adults, but they can’t get jobs, pay the bills, drive a car, or do the daily functions of fully mature humans. Likewise, promyelocytic blood cells are too underdeveloped to perform the roles of fully mature white blood cells in the body.
Signs and Symptoms
People with APL have many of the same symptoms as other types of AML. Most of the signs of leukemia are the result of cancer cells “crowding out” thebone marrowand interfering with the production of normal, healthy red blood cells, white blood cells, and platelets.
These signs and symptoms include:
In addition to these signs of AML, people with APL also have other characteristic symptoms.
They will often have:
Girls and women with APL may notice unusually heavy menstrual periods.
The symptoms of leukemia can be vague, and may also occur with other, non-cancerous conditions. If you are concerned about your health, or the health of a loved one, it is always best to seek the advice of a medical professional.
The treatment of APL is verydifferent than that of other types of acute leukemia, so properly identifying it is critical.
Most people with APL are treatedinitially with a combination of all-trans retinoic acid (ATRA), a specialized form of vitamin A and with arsenic trioxide (ATO). ATRA therapy is unique in that it forces the promyelocytic leukemia cells to mature, a bit like how graduating college forces the teenagers in our comparison into the adult role (well, at least sometimes). This phase of treatment is referred to as “induction.”
For many people, the combination of ATRA and ATO is curative. For some people,chemotherapytreatment is used as well.
After initial treatment, ATRA is often continued for at least a year, sometimes combined with other medications. This last phase of treatment is called “maintenance.”
Treatment of APL is successful in the vast majority of cases.
Coping and Support
Even though APL has an excellent prognosis, the diagnosis and treatment process can be exhausting for you. Make sure you give yourself time to rest. Consider reaching out to family and friends—and accept their help.
Take time to learn about survivorship andcoping. When cancer treatment ends, instead of elation, many people feel depressed. Persistent side effects of treatment and time spent on the emotional roller coaster of cancer can leave you wondering if you will ever feel normal again. There are resources to help cancer survivors thrive. Studies actually tell us that cancer changes people in good ways, not just bad.
Leukemia Doctor Discussion GuideGet our printable guide for your next doctor’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
Download PDF
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4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Baljevic M, Park JH, Stein E, Douer D, Altman JK, Tallman MS.Curing all patients with acute promyelocytic leukemia: are we there yet?Hematol Oncol Clin North Am. 2011;25(6):1215–viii. doi:10.1016/j.hoc.2011.10.002
U.S. National Library of Medicine Genetics Home Reference.Acute promyelocytic leukemia.
National Organization for Rare Disorders.Acute Promyelocytic Leukemia.
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