E-Book

E-Book 3rd Congress

  • Acute promyelocytic leukemia (APL) Detection
  • Shahla Rahmani,1,* Mahsa Loran Esfahani,2 Sahar Ghiasi,3
    1. MSc of Hematology and Blood banking Department of Medical Laboratory Sciences, School of Allied Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
    2. MSc of Hematology and Blood banking Department of Medical Laboratory Sciences, School of Allied Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
    3. MSc of Hematology and Blood banking Department of Medical Laboratory Sciences, School of Allied Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran


  • Introduction: Adult acute myeloid leukemia (AML) is a type of cancer in which the bone marrow makes a large number of abnormal blood cells. Leukemia may affect red blood cells, white blood cells, and platelets. There are different subtypes of AML. Acute promyelocytic leukemia (APL) is a subtype of AML. This leukemia occurs when genes on chromosome 15 switch places with some genes on chromosome 17, and an abnormal gene called PML::RARA is made. The PML::RARA gene sends a message that stops promyelocytes (a type of white blood cell) from maturing. APL usually occurs in middle-aged adults.
  • Methods: APL tests for diagnosis: Full blood count (FBC) measures the number of each type of cell in blood, Bone marrow biopsy It’s not normally possible to diagnose APL with just a blood test. There may be leukaemia cells in bone marrow that aren’t in blood yet. Cytogenetics Specialist doctors will look at chromosomes 15 and 17 in the abnormal cells. If these chromosomes are mixed up, this confirms a diagnosis of APL. Polymerase chain reaction (PCR) test will check cells from bone marrow sample for the PML/RARA gene, because only people with APL have this gene. Immunophenotyping (flow cytometry), looks at the pattern of proteins on the surface of leukaemia cells. Together with the other tests, it helps doctors to confirm whether patient have APL or another type of leukaemia.
  • Results: Problems with severe bleeding and blood clots may occur. This is a serious health problem that needs treatment as soon as possible. Bleeding can become life-threatening if it’s not treated straight away, So patient may need regular blood and platelet transfusions to lower risk of bleeding. Treatment of newly diagnosed APL includes: All-trans retinoic acid (ATRA) plus arsenic trioxide (ATO) for low-risk to intermediate-risk disease. ATRA plus combination chemotherapy followed by ATO for high-risk disease.
  • Conclusion: There are also some other tests you will need once you’re diagnosed: Blood clotting system tests APL can affect the blood clotting system in body, and increase the risk of bleeding and blood clots. General health tests: Patient will have a general health check to assess how patient is likely to cope with the side effects of treatment. This will involve a range of tests to check patient's heart, liver and kidney function, and may include screening for HIV and hepatitis.
  • Keywords: Acute promyelocytic leukemia, APL, PML::RARA, Diagnosis, AML