Hi Dr,

How are you doing today?This is Jeevana wants to ask few question regarding APL...One month back my husband was detected with APL,He was hospitalized for 30days n took his treatment(Atra+idarubicin) from Stanford clinics,he is in remission now..Today they performed bone marrow biopsy n waiting for the results to come... so i want to know like how can we know whether this APL is going to relapse...if it relapses what to do?and what will be the survival rate for this APL...bcz we got married very recently say one n half yrs back...so we all want him to be back to his noraml life.....pls kindly reply to all my questions...if u need any further details mail me personally...Appreciate for quick reply

Thanks
JJ

Thank you for your question.

No one can predict which patients will relapse after remission. This is why it is important to follow with your doctor so he/she can monitor symptoms and perform tests to ensure the disease does not relapse.

I don't know all the details about your husband's case, but I will assume that he completed his induction therapy (ATRA & idarubicin) which is performed in-hospital. The bone marrow biopsy will indicate his response to treatment (looks at the cells).

Usually, about 90-95% of patients have complete remission after induction therapy (the first treatment). The next step is to continue with consolidation therapy (usually 2 cycles) because it was found that many patients relapse without it.

Survival is measured over the number of years that have been observed in clinical trials. The three year survival for low-risk patients is excellent (up to 97%). However, intermediate and high risk patients have lower survival.

In the minority of patients that fail to show complete remission after induction (first cycle of therapy), then additional therapy is needed before proceeding to consolidation therapy, likely using Arsenic Trioxide.

After consolidation therapy, there is the option of maintenance therapy. Maintenance therapy may not be necessary for all patients (e.g. those with complete molecular remission), but this is a discussion you will have with your doctor when the time comes.

In general, patient diagnosed with APL have good response to therapy and good survival because of the genetics of the disease and its response to ATRA.