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The Fellow on Call: The Heme/Onc Podcast

Episode 114: Acute Promyelocytic Leukemia (REBOOT!)

Sep 4, 2024
Delve into the urgent challenges of managing acute promyelocytic leukemia with insights on its diagnosis and treatment. Discover how the disease's classification as a hematologic emergency has evolved, leading to new management strategies. Listen in on a complex case highlighting critical lab findings indicative of acute leukemia. Understand the unique features of APL and the role of the PML-RARA fusion gene, along with urgent strategies addressing complications like differentiation syndrome for improved patient recovery.
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Quick takeaways

  • Acute Promyelocytic Leukemia (APL) is diagnosed using specific laboratory tests, highlighting the importance of early recognition for effective management.
  • Recent treatment advances have transformed APL into a highly curable condition, achieving cure rates exceeding 90% through prompt intervention.

Deep dives

Understanding Acute Promyelocytic Leukemia (APL)

Acute Promyelocytic Leukemia (APL) is a subtype of acute myeloid leukemia (AML) characterized by a specific genetic translocation between chromosomes 15 and 17, leading to a fusion of the promyelocytic leukemia gene and the retinoic acid receptor gene. This condition was once associated with a high mortality rate due to complications such as disseminated intravascular coagulation (DIC) and severe bleeding. However, advancements in treatment have transformed APL into one of the most curable forms of leukemia, with cure rates now exceeding 90%. The early recognition of APL is critical since it is considered a hematologic emergency, necessitating immediate intervention to improve patient outcomes and prevent complications.

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