Acute promyelocytic leukemia: an overview with implications for oncology nurses

Acute promyelocytic leukemia (APL), once described as the form of leukemia with the highest mortality, is now the most potentially curable subtype of adult acute myeloid leukemia. A brief review of the history of APL will describe the advances in research and clinical practice and their impact on patient outcomes. Oncology nurses should familiarize themselves with the nuances of APL because of the critical role nurses play in providing support for patients. This article provides an overview of APL, including the epidemiology and pathophysiology that distinguishes APL from other types of acute leukemia. Clinical presentation and diagnostic workup for patients suspected of having APL will be reviewed, as will the treatment course. Nursing implications and management will be provided related to potential treatment complications specific to APL, including coagulopathies, differentiation syndrome, and QT prolongation with the use of arsenic trioxide, as will the side effects and complications that can occur in any patient with leukemia, such as infection, hyperleukocytosis, tumor lysis, and increased intracranial pressure.