What is acute promyelocytic leukaemia (APL)?

Acute promyelocytic leukaemia (APL) is a type of acute myeloid leukaemia (AML). It affects about 6 in 100 (6%) adults with AML.

The tests and treatments used for APL are the same as AML. However, treatment for APL may also include the following drugs.

ATRA (All Trans-Retinoic Acid)

ATRA is also known as tretinoin (Vesanoid®). This drug makes the leukaemia cells develop fully. This can reduce leukaemia symptoms very quickly.

You take ATRA every day as capsules with food. It is usually given with chemotherapy or the drug arsenic trioxide.

Side effects can include:

  • headaches
  • dry skin and mouth
  • feeling sick (nausea)
  • bone pain
  • dry eyes.

Arsenic trioxide (ATO, Trisenox®)

This drug damages the leukaemia cells. It is given into a vein through a drip.

Side effects can include:

  • heart changes
  • diarrhoea
  • tiredness
  • muscle and bone pain
  • a high temperature
  • raised blood sugar.

About our information

  • References

    Below is a sample of the sources used in our acute myeloblastic leukaemia (AML) information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

    British Committee for Standards in Haematology. Milligan DW et al. Guidelines on the management of acute myeloid leukaemia in adults. British Journal of Haematology. 2006. 135: 450–474. 

    Fey MF and Buske C. Acute myeloblastic leukaemia in adult patients: ESMO clinical practice guidelines. Annals of Oncology. 2013. 24 (Supplement 6): vi138-vi143.

    National Institute for Health and Care Excellence. Blood and bone marrow cancer. www.nice.org.uk/guidance/topic/conditions-and-diseases/blood-and-immune-system-conditions/blood-and-bone-marrow-cancers (accessed July 2018).


  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Anne Parker, Consultant Haematologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.