A 56-year-old woman, Ms. Chen, felt ill with fever and came to the First Affiliated Hospital of the University of Heilongjiang. Based on the patient’s routine blood tests and coagulation, Dr. Kuang-Hua Yan, Chief of Hematology, suspected that the patient had acute promyelocytic leukemia (APL).
In order to further confirm the diagnosis, a bone marrow aspiration was performed and the results were partially supportive of APL, and Dr. Yan immediately considered the possibility of a rare clinical atypical APL (i.e., variant APL). Dr. Yan gave the patient retinoic acid induction therapy and aggressive symptomatic supportive therapy, and at one and a half months of induction therapy, a review of the bone marrow showed complete remission, and the patient was to undergo follow-up therapy.
APL is a specific type of acute myeloid leukemia (AML) and is designated as AML type M3. It is not uncommon in the clinical setting. More than 98% of clinical APL is caused by translocation between chromosome 15 and chromosome 17, and only rarely is it a variant chromosome translocation between chromosome 5 and chromosome 17. Ms. Chen suffers from this variant of APL, and it takes several years of persistent treatment to cure this disease.