Signs and symptoms of APL
Acute promyelocytic leukemia (APL) can cause many different signs and symptoms. Many patients will
experience several generalized symptoms, such as weight loss, unusual fatigue, fever, and loss of
appetite, which are not specific to APL.
1 The signs and symptoms specific to APL result
from a shortage of normal blood cells due to crowding out of normal blood cell-producing bone marrow
by the leukemia cells.
1
Common signs and symptoms of APL include:
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- Feeling tired or short of breath. This may be an effect of anemia, which is a shortage of red blood cells.
- Pale complexion from anemia
- Slow healing of cuts or frequent minor infections. APL is usually associated with a shortage of normal white blood cells (a condition called leukopenia) and, in particular, too few mature granulocytes (neutropenia or granulocytopenia). This results in a higher risk of infections. Although leukemia is often a cancer of white blood cells and patients with leukemia may have very high white blood cell counts (leukocytosis), the abnormal leukemia cells do not protect against infection.
- Mild fever or swollen glands
- Discomfort in bones or joints. Some patients with APL may have bone pain or joint pain caused by the spread of leukemic cells to the surface of the bone or into the joint from the marrow cavity. When leukemia cells spread outside the bone marrow, the condition is called extramedullary spread.
- Bruising easily and bleeding. A hallmark of APL is a tendency to bleed. Because of the increased risk of bleeding, there is reason for urgency in the treatment of the disease. The disorder in clotting has historically been called disseminated intravascular coagulopathy (DIC) but is now thought to be a more complicated consequence of the leukemic cells. It can lead to excessive bruising, bleeding, frequent or severe nosebleeds, bleeding from the gums, blood in the urine, and excessive bleeding during menstruation or after needle sticks for blood draws. More serious bleeding may also occur before the disease is under control.
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1. American Cancer Society. How Is Acute Myeloid Leukemia (AML) Diagnosed? Available at:
http://www.cancer.org. Accessed September 1, 2006.