Medical Oncology

, 30:625 | Cite as

Therapy-related acute promyelocytic leukemia: a systematic review

  • Armin Rashidi
  • Stephen I. Fisher
Review Article


The incidence of therapy-related acute promyelocytic leukemia (t-APL) is apparently rising. We systematically reviewed the English literature until March 15, 2013, and collected a total of 326 t-APL cases, with the following results: (1) t-APL affects predominantly middle-aged adults with a median age at diagnosis of 47 years and a female-to-male ratio of 1.7:1; (2) after an incidence peak at 2 years following the completion of treatment for the primary antecedent disease, the risk of developing t-APL quickly diminishes with time; (3) the four most common primary antecedent conditions are breast cancer, hematological malignancies, multiple sclerosis, and genitourinary malignancies; (4) topoisomerase II inhibitors and radiation represent the most common potential risk factors; (5) despite different DNA damage “hot spot” sites, t-APL has no significant clinicopathologic differences from de novo APL (dn-APL); (6) t(15;17) is the sole cytogenetic abnormality in the vast majority of patients; (7) only a small minority of cases have a myelodysplastic or pancytopenic preleukemic phase; (8) more than one-third of patients come to medical attention incidentally (i.e., due to laboratory abnormalities), while the most common symptom is mucocutaneous bleeding, and 79 % have clinical DIC; and (9) the remission rate of t-APL is about 80 %, similar to dn-APL.


Leukemia Promyelocytic Secondary Therapy 


Conflict of interest


Supplementary material

12032_2013_625_MOESM1_ESM.docx (104 kb)
Supplementary material 1 (DOCX 103 kb)


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Internal MedicineEastern Virginia Medical SchoolNorfolkUSA
  2. 2.Pathology Sciences Medical GroupSentara Laboratory ServicesNorfolkUSA

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