What is Acute Promyelocytic Leukemia (APL)?

With a title like “What is Acute Promyelocytic Leukemia?” how can you resist reading this post?  That’s what you call a hook, folks!

My story left off with being diagnosed with leukemia, and more specifically, the subtype APL.   But, before I go further, I think I should give you a brief explanation of what this means.  Bear with me… a scientist I am not.

My Laymen’s Definition of Leukemia

Leukemia is a bone marrow and blood cancer.  Our bone marrow produces all three components of blood – the red cells, white cells, and platelets.

Having leukemia means that white blood cells never develop to maturity.  White blood cells are our fighter cells and so a leukemic person with non-functioning immature white cells is vulnerable to infection.  For me, this means wearing a mask and isolating myself when my white cells are low.

The other components of blood are the red blood cells and the platelets. The red blood cells carry oxygen and carbon dioxide between the lungs and the rest of the body. Platelets contain clotting factors that prevent excessive bleeding. With leukemia, the red cells and platelets often fail to proliferate. So, a person may be anemic and at a risk of bleeding excessively. Blood and/or platelet transfusions may be used to increase these levels.  So far, I have received seven blood transfusions and one platelet transfusion.  Low counts for red cells, white cells, and platelets are common symptoms when a person is first diagnosed with leukemia.  This was the case with me.

Acute Promyelocytic Leukemia (APL)

APL is a subtype of acute myelocytic leukemia (AML). ‘Acute’ refers to the rapid onset of the disease.  And rapid it is!  I went from feeling healthy to nearly dying of a hemorrhage within months.  When I entered the hospital my bone marrow was packed 100% with leukemic blast cells.  ‘Myelocytic’ refers to those cells that produce the granulocytes. My specific variant of APL is the M3 form. This is shown by a translocation at chromosomes 15 and 17 (t15:17).   In other words, parts of my 15 and 17 chromosomes switched places.  Bizarre, right?  The result is that the promyelocytes do not develop into mature granulocytes, hence the immature cells (leukemia).

APL is rare, and there is no way to know the cause of my leukemia.  Even though my mom passed away from leukemia, she had a completely different kind and it was not considered hereditary.  APL is also not hereditary.  It is thought that APL is caused by environmental exposures, but I do not recall having been exposed to anything other than what’s normal in someone’s day to day life.  The “why” will remain a mystery.

Now that we’re all up to speed, I’ll return to my story… 

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20 thoughts on “What is Acute Promyelocytic Leukemia (APL)?

  1. Tina Mason

    You just keep on giving………….My elderly Father is being tested for Leukaemia he is having a transfusion next week. You are young and strong and will put up a winning fight with us behind you how can you fail? Big HUGS xx

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  2. I read it and I am sending it to our granddaughter, Bakah, at NAU who is majoring in Forensics.​ Then, I’m going back to your site to see if I can find the background picture. I know! I’ll look on my toolbar!

    On Wed, Dec 9, 2015 at 12:26 PM, Sarandipity Travels wrote:

    > Sarandipity Travels posted: “With a title like “What is Acute Promyelocytic Leukemia?” how can you resist reading this post? That’s what you call a hook, folks! My story left off with being diagnosed with leukemia, and more specifically, the subtype APL. >”

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    1. David, I’m very sorry to hear about your son. I lost my son, Shawn, 11 years ago and so my heart aches for you and what you’re going through. Life is never the same, and there’s not a day that goes by that I don’t think of him. Very early on I joined a support group called The Compassionate Friends. It’s completely run by parents that have lost children so I felt like it was the one place I could go where people truly understood. There are chapters all over the world. Perhaps it is something that might help you too. I’m sending you a very compassionate hug. I’m so sorry. https://www.compassionatefriends.org

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    1. Ruby, I’m very sorry to hear about your mom. I grew up with my mom having leukemia. Never thought I’d end up dealing with it too. I have to say, I felt like a vampire in the hospital. I loved when they gave me the blood transfusions because it made me feel so much better! I’m sending both you and your mom healing thoughts!

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  3. Kristie

    I had to find out the same way what APL, I also went from feeling good to slowly feeling worse over about 2.5 months. My grandmother on my mom’s side died from leukemia but they didn’t know all of the different kinds then. Crazy roller coaster but you have to fight, stay strong!!!!

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    1. Thanks for reading, Margaret Ann. I know the material is a bit dry, but I thought it was helpful to explain before going forward with my story. 🙂 I’m amazed your husband gave so many bags of platelets. Incredible! When I was receiving my transfusions I’d look at the bags and wonder about the person that gave. I’m so grateful for them.

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  4. Linda Artley

    Beautifully stated so that anyone can understand it. Your writings are meant to help others as well as yourself, Sara. I feel you do so with each chapter and verse. I will only add that from Denny having 4 back operations I do know that you either have to be proactive in your care or someone must be on top of things for their loved one. You’ve got this, Sara or as they say “You’re all over it” Love you lots. I’ll look forward to the next one!

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    1. Linda, what you’ve said about helping others with my writing is appreciated! When I was first diagnosed, I scoured the web looking for blogs by people with APL and read the few I found from top to bottom. It helped not to feel alone and to have an idea of what might lay ahead. When I’m writing, I think about those that might be doing the same thing with my blog.
      And as far as being proactive, OMG is that important! Thanks for always knowing just what to say to me. “We’ve” got this, friend! Love you. x x x

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  5. Tammie Wilson

    Dear Dear Sarah, I was dumbfounded and crushed when i found out you were going through this, this has been such a hard year for so many. I know you are a very strong woman, (look at all you have had to go through. and still come out stronger than ever) You are in my thoughts a lot and in my prayers all the time .. Big hugs to you my dear. and sending you lots and lots of love. Thank you for sharing your experience with us. It means so much. you hang in there and know that you have so many people who love you and support you.
    (yes, its odd.. considering the history with us, 😉 but i am sooo glad we made it past all that), you are such a remarkable woman and I am so thrilled that I have you in my life, in if it’s through posts, and happy memories of time with your Gorgeous and truly special children.. (no matter how limited the time – my heart still grieves every day) God Bless you! and your family! – Tammie

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    1. Tammie, what a beautiful, heartfelt message. Thank you. I’m so glad that our lives crossed paths, as strange as the circumstances were. You’re a wonderful person and have been a good friend over the years. I’m sending you love back!

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  6. Duane Schlieder

    It took me a few days to get back to reading it all, but I want to understand as much as I can. Thank you for educating us! Continue to heal dear friend!

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