Haematology-Oncology · Pathway 40

Acute Promyelocytic Leukaemia

Reference Linear

Key points

You are not usually expected to differentiate AML subtypes for MRCP, with one exception: acute promyelocytic leukaemia (APML, the M3 subtype).
Presents younger than other AML (average around 25 years).
Driven by the t(15;17) PML-RARA translocation; DIC/coagulopathy is common at presentation and is the main early killer.
Treatment: start ATRA (all-trans retinoic acid) URGENTLY on clinical suspicion, before genetic confirmation, to reduce early death from DIC — combined with arsenic trioxide (or chemotherapy). Excellent prognosis with modern therapy; watch for ATRA/differentiation syndrome.