This may be done by polymerase chain reaction PCR , fluorescent in situ hybridization FISH , or conventional cytogenetics of peripheral blood or bone marrow. This mutation involves a translocation of the long arm of chromosomes 15 and On rare occasions, a cryptic translocation may occur which cannot be detected by cytogenetic testing; on these occasions PCR testing is essential to confirm the diagnosis.
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ATRA alone is capable of inducing remission but it is short-lived in the absence of concurrent "traditional" chemotherapy. ATRA therapy is associated with the unique side effect of retinoic acid syndrome.
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The monoclonal antibody, gemtuzumab ozogamicin , has been used successfully as a treatment for APL,  although it has been withdrawn from the US market due to concerns regarding potential toxicity of the drug and it is not currently marketed in Australia, Canada or the UK.
After stable remission was induced, the standard of care previously was to undergo 2 years of maintenance chemotherapy with methotrexate , mercaptopurine and ATRA. However, recent research on consolidation therapy following ATRA-ATO, which became the standard treatment in , has found that maintenance therapy in low-risk patients following this therapy may be unnecessary, although this is controversial.
Remission with arsenic trioxide has been reported. Some evidence supports the potential therapeutic utility of histone deacetylase inhibitors such as valproic acid or vorinostat in treating APL. Prognosis is generally good relative to other leukemias. Because of the acuteness of onset compared to other leukemias, early death is comparatively more common.
If untreated, it has median survival of less than a month. It has been transformed from a highly fatal disease to a highly curable one.
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The cause of early death is most commonly severe bleeding, often intracranial hemorrhage. Risk factors for early death due to hemorrhage include delayed diagnosis, late treatment initiation, and high white blood cell count on admission. Relapse rates are extremely low. Incidence is higher among individuals of Latin American or South European origin. From Wikipedia, the free encyclopedia. For other uses, see APL disambiguation. This article needs to be updated.
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Please update this article to reflect recent events or newly available information. May Anemia Fatigue Weakness Chills Depression Difficulty breathing dyspnea Low platelets thrombocytopenia leading to easy bleeding Fever Infection as a result of low neutrophils neutropenia Elevated white blood cells leukocytosis Coagulopathy including DIC. Medscape Reference. Retrieved 14 January Acta Med Scand.
Blood Cancer Journal. An independent study finds that only 1. Analysis 08 August Views. Disrupting the Clinical Research Industry.
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