Understanding Aggressive Acute Promyelocytic Leukemia

A rare subtype of leukemia that requires immediate medical attention. Time is critical with APL—awareness saves lives.

What Is Aggressive APL?

Aggressive Acute Promyelocytic Leukemia (APL) is a rare and rapidly progressing subtype of acute myeloid leukemia (AML), characterized by the accumulation of immature white blood cells known as promyelocytes. Unlike other leukemias, aggressive APL poses a critical and immediate threat to life, often within hours or days if left untreated.

APL is considered a medical emergency. While advances in treatment have improved survival rates, the speed at which aggressive APL can cause complications—particularly bleeding and clotting disorders—makes early detection and swift intervention absolutely vital.

APL Info

⚠️ Why It's Called "Aggressive"

APL is already rare. But aggressive APL refers to cases where symptoms progress extremely rapidly, leading to:

  • Life-threatening bleeding in the brain or lungs
  • Severe fatigue, infections, and organ dysfunction due to extremely low blood counts
  • Disseminated intravascular coagulation (DIC) – a serious clotting disorder
  • Sudden onset symptoms such as fever, bruising, nosebleeds, or shortness of breath

Immediate treatment can save lives. This is why awareness and action matter—most families don't even know what APL is until they're in crisis.

APL symptoms

Signs & Symptoms to Watch For

If you or someone you love is experiencing the following symptoms, especially in combination, seek medical attention immediately:

  • ⚠️ Unexplained bruising or bleeding
  • ⚠️ Frequent nosebleeds or bleeding gums
  • ⚠️ Small red spots on the skin (petechiae)
  • ⚠️Severe fatigue or weakness
  • ⚠️ Frequent infections or fevers
  • ⚠️Shortness of breath
  • ⚠️ Bone pain or chest discomfort

These symptoms can mirror other conditions—but with APL, time is everything.

🧪 Diagnostic Testing

Diagnosis involves several tests, including:

Complete Blood Count (CBC)

Checks for abnormal white and red blood cell levels and platelets

Bone Marrow Biopsy

Confirms the presence of promyelocytes

Genetic Testing (FISH or PCR)

Identifies the PML-RARA gene fusion specific to APL

Once diagnosed, patients are typically started on all-trans retinoic acid (ATRA) and arsenic trioxide (ATO)—a combination that has significantly improved survival rates when caught early.

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APL symptoms

Our Role in the Fight

At the Sherelle McKinley Thomas Leukemia Foundation, we are committed to:

  • ⦁ Raising awareness of aggressive APL to shorten diagnosis delays
  • ⦁ Providing financial and emotional support to families navigating the journey
  • ⦁ Advocating for early testing protocols in emergency rooms and urgent care settings
  • ⦁ Supporting research that advances detection and treatment of rare, aggressive leukemias

We understand the devastation a late diagnosis can bring—because we’ve lived it. That’s why we are committed to standing in the gap.

Resources

Access these essential tools and resources to help navigate the APL journey. Knowledge and support are powerful allies in this fight.

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APL Quick Facts

Essential information about APL in an easy-to-reference format. Share with healthcare providers.

PDF Document (2 pages)

Download PDF
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Virtual Support Community

Connect with others who understand the APL journey. Weekly virtual meetings.

Weekly Zoom Meetings

Coming Soon
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Financial Support Guide

Information about eligibility and application process for our financial assistance program for APL patients.

Grants up to $5,000

Coming Soon

Questions to Ask Your Doctor

At Diagnosis

  • How certain is the APL diagnosis? What tests confirm it?
  • How quickly should treatment begin, and what are our first steps?
  • What is the treatment plan and expected timeline?
  • Should we seek care at a specialized center for APL?

During Treatment

  • What side effects should we watch for and report immediately?
  • How do we know if the treatment is working?
  • What supportive care is needed during treatment?
  • Are there any clinical trials that might be appropriate?

You're Not Alone

Whether you're newly diagnosed, supporting a loved one, or grieving a loss—we see you. We honor your fight, your strength, and your story.

🕊️ In Loving Memory of Sherelle

This page—and our entire mission—is dedicated to the life and legacy of Sherelle McKinley Thomas, whose battle with aggressive APL inspired a foundation committed to ensuring no one walks this journey alone.