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Acute Promyelocytic Leukaemias

For APML, BM samples can indicate increased risk of relapse much earlier than PB. Residual transcript detection, following completion of treatment, is highly indicative of an increased risk of relapse. Paired PB and BM samples are the most informative specimens for MRD monitoring. As with all MRD, a pre-treatment diagnostic level is important to look at log reduction in levels over time.

In APL, there is also the advantage of being able to detect the genetic lesion in molecular assays if cytogenetic testing is unable to detect the translocation due to technical issues with the sample. This helps to confirm the diagnosis and inform clinical management of the patient.