Refractory Acute Promyelocytic Leukemia
What Is Refractory Acute Promyelocytic Leukemia (APL)?
Refractory acute promyelocytic leukemia (APL) is an advanced form of the blood cancer acute myeloid leukemia (AML). It's a rare but aggressive form of AML that happens when cells in a person's bone marrow make too many promyelocyte cells, which are unlike normal white blood cells. This leads to an overproduction of immature white blood cells, or leukocytes, that can't fight infection. Symports of APL include easy bruising and bleeding, fatigue, and frequent infections.
Refractory APL is a particularly aggressive form of APL and is harder to treat. People with refractory APL have not responded to chemotherapy and often times require more intensive treatment such as stem cell transplantation. It is important to quickly identify this subtype of APL so that appropriate treatment can be started as soon as possible.
Signs and Symptoms of Refractory APL
Signs and symptoms of refractory APL are similar to those of other types of AML and can include:
- Fever
- Weight loss
- Frequent infections
- Unusual bleeding or bruising
- Pale skin
- Fatigue
- Shortness of breath
Diagnosis and Treatment of Refractory APL
Diagnosis of refractory APL involves a physical examination and bone marrow biopsy to diagnose the specific type of leukemia. Treatment of refractory APL typically includes chemotherapy, radiation therapy, or a stem cell transplant.
Chemotherapy is a common first line of treatment, and usually involves a combination of drugs. Radiation therapy may also be used to reduce the number of cancer cells. Stem cell transplant is a newer form of treatment used to replace damaged cells with healthy cells. In some cases, a combination of chemotherapy, radiation therapy, and stem cell transplant may be used.
Outlook for Refractory APL
Prognosis for refractory APL can vary depending on how timely the diagnosis and treatment is. The outlook is generally better for people who have an early diagnosis and start treatment quickly. Those who do not respond to initial treatment have a worse outlook.
For all types of APL, the success rate of treatment is higher in people whose leukemia is diagnosed and treated early. It is important to seek medical attention if you have any symptoms that may be related to APL, including fatigue, easy bruising or bleeding, or frequent infections.