When was acute promyelocytic leukemia (APL) first recognized?

Updated: May 03, 2019
  • Author: Sandy D Kotiah, MD; Chief Editor: Emmanuel C Besa, MD  more...
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APL was first described as an entity in the late 1950s in Norway and France as a hyperacute fatal illness associated with a hemorrhagic syndrome. [1] In 1959, Jean Bernard et al described the association of APL with a severe hemorrhagic diathesis that led to disseminated intravascular coagulation (DIC) and hyperfibrinolysis. By 1973, there were reports of complete remissions with treatment of the disease by daunorubicin.

In 1974, Leo Sachs pioneered research on leukemic cell differentiation in vivo. Dr. Zhen Yi Wang, a Chinese hematologist, shared data on the efficacy of all-trans retinoic acid (ATRA) in his APL patients during a visit to France in 1985. In 1990, several publications linked a translocation between chromosomes 15 and 17 to the pathology of APL. In the early to mid 1990s, arsenic trioxide (ATO) was added to the treatment regimen. A potentially fatal complication of ATRA treatment, called retinoic acid syndrome, was also described. Over the past 50 years, APL has transformed from a highly fatal disease to a highly curable one. [2]

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