Acute promyelocytic leukemia: Problems of diagnosis and current therapeutic opportunities.

Current therapy of acute promyelocytic leukemia (APL) has a great potential suggesting APL principal curability. Therefore, the impotance of accurate and early diagnosis is growing. This article provides analysis of blast cells features in 34 cases of APL and concerns some therapeutic approaches in APL; contains criteria of morphological diagnosis of APL and comparative results of APL treatment in two groups of patients: treated according to the program including ATRA and not including one. The data of the study show that morphological diagnosis of APL rests primarily on the presence of promyelocytes with bilobular nuclei accounting for 25% and more of the blast population. The chromosomal analysis detects specific translocation t(l 5; 17) and/or characteristic chymeric gene PMURARalpha. The other morphological parameters (content of macroforms, grain, Auer bodies, Hitachi bodies) and immunophenotypical parameters are less important in the diagnosis. Atypical morphological picture requires additional cytogenetic and/or molecular-genetic examination for the diagnosis and determination of APL variant. The analysis of the results of various therapeutic programs found noticeable improvement of short-and long-term results in patients given combined cytostatic and differentiated therapy.