Q. My husband has APL and BMA shows 3% on FISH RARA. Is it minimal residual disease?

Answered by
Dr. Parth R Goswami
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Mar 17, 2020 and last reviewed on: Mar 26, 2020

Hi doctor,

My husband was diagnosed with APL before six years. He underwent treatment by following the pethema protocol for APL. After consolidation phase, BMA revealed there is still 7% of PML Rara using fish rara test while negative on cytogenetics. His doctor proceeded to his maintenance phase two years on ATRA, Mercaptopurine, and Methotrexate. For two years monitoring blood counts are within the normal range. BMA was done this year and revealed there is still 3% on FISH Rara. Is this considered a minimal residual disease? Or incomplete remission? Does he need to undergo chemo again or start a new ATRA?

Dr. Parth R Goswami

Hematology Pathology


Welcome to icliniq.com.

Sorry to hear about your husband's diagnosis. He is having acute promyelocytic leukemia cancer and it is considered among favorable outcome leukemia.

After starting chemotherapy complete remission includes less than 5% blast in bone marrow aspirate, ANC more then 1500, platelets more than 1 lakh, extramedullary hematopoiesis absent and molecular testing negativity.

After consolidation chemotherapy, if cytogenetic study remains positive then prognosis cannot be considered good as compared to a negative cytogenetic leukemic patient after chemotherapy and it can be considered here as a minimal residual disease.

Treatment was given in the right way along with proper chemotherapy and retinoic acid as well. But you have to discuss your case with your treating oncologist and he will guide you further about what is the future treatment protocol.

I hope this helps.

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