Acute promyelocytic leukaemia

What it is

Acute promyelocytic leukemia is one subtype of acute myeloid leukemia, the M3, and it is defined by its molecular abnormality: PML-RARA, with t(15:17). In the WHO 2016 list of AML and related neoplasms it stands in the group with recurrent genetic abnormalities, written there as APL with PML-RARA, alongside AML with t(8;21) RUNX1-RUNX1T1, AML with inv(16) or t(16;16) CBFB-MYH11, and the rest.

What can go wrong

The one thing that sets APL apart in daily care is bleeding. Acute myeloid leukemia releases a pro-coagulant, and the release of procoagulants leads to DIC, with the higher risk in APL. That is why DIC risk is listed as a key feature of PML-RARA, alongside Auer rods and hypergranular promyelocytes.