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Acute promyelocytic leukaemia (APL) symptoms

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The main symptoms of APL are caused by not having enough healthy blood cells.

Bruising and bleeding

In APL, your body can’t make enough platelets and clotting factors. Platelets are blood cells that stop bleeding by making the blood clot. Clotting factors help platelets to stick together to form a clot. Without enough of these, you can bruise and bleed easily. You may experience:

  • bruising easily
  • bleeding gums
  • bleeding from wounds that’s hard to stop
  • poo that is either black and tarry or streaked with red, because of bleeding in your gut
  • headaches, difficulty speaking or difficulty moving parts of the body, because of bleeding in the brain.

Blood clots

APL affects the blood’s clotting factors, which help your blood to clot. This means blood clots can form in the wrong places and can lead to:

  • a painful or swollen leg – due to clots in the leg or lower abdomen (tummy area)
  • chest pain and difficulty breathing – due to blood clots in the lungs
  • headache, being sick (vomiting) and problems with vision due to blood clots in the brain.

Tell your doctor straight away if you have any of these symptoms, or any other symptoms that you are worried about.


Fatigue is when you’re totally drained in body and/or mind. Fatigue can hit even when you’ve rested or slept well. It’s caused by having low numbers of red blood cells (anaemia).

Anaemia can also make you feel breathless and can lead to chest pain.


If you have low numbers of white blood cells, you may get more infections and fevers, or infections and fevers may last longer than normal.

Weight loss

This is caused by a high metabolism, which is the rate at which you burn energy from food. We don’t completely understand why the metabolism speeds up in people with APL.

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