Acute promyelocytic leukaemia (APL) treatment

In this section we talk about the specific treatments used for APL. You might also want to read our general information section about how blood cancer treatment is planned and managing your treatment.

We also have some important information on staying safe if you’ve got blood cancer, covering things like risk of infection and vaccinations.

If your doctor thinks you have APL, you will probably start treatment while your doctor is doing more tests to confirm your diagnosis. This is because until you start treatment, you’re at risk of serious bleeding. If your diagnosis and treatment plan then change, the treatment you’ve already received won’t do you any harm.

Your doctor will recommend a treatment plan and talk to you about what it will involve. Treatment plans are tailored to each person. You might not have the same treatment as someone else with APL. What’s right for you depends on your age, your general health and the type of APL you have.

The treatment you have first is called ‘first-line treatment’ or ‘first-line therapy.’

You will have first-line treatment in two stages:

1. remission induction
2. consolidation

The aim of this treatment is to put you into ‘complete remission’. Your healthcare team may call this ‘morphological remission’. This means that the level of leukaemia cells in your bone marrow is less than 5% and doctors can’t see any leukaemia cells under the microscope. You’ll probably spend a lot of this stage in hospital, with your healthcare team close by.

You will then have more rounds (or cycles) of treatment to clear any leukaemia cells that might remain in your blood and bone marrow (the spongy material inside your bones, where blood cells are made). These cells can’t be seen through a microscope but can be picked up by a PCR test which you’ll have after each round of treatment. When the PCR test can’t pick up any leukaemia cells, this is called ‘complete molecular remission’.

You might be able to have some of these treatments as an outpatient, which means you won’t need to stay in hospital overnight. But you will still have to go to hospital for treatment and check-ups.