A Simplified Patient Care Strategy to Decrease Early Deaths in Acute Promyelocytic Leukemia (APL)

• Confirmed to have a diagnosis of APL, which is defined as:

‣ Positive t(15:17) by fluorescence in situ hybridization (FISH) or conventional karyotype

⁃ Positive promyelocytic leukemia/retinoic acid receptor PML/RAR alpha by polymerase chain reaction (PCR)

• Patients must accept treatment and supportive care guidelines

• Referrals must be made as early as possible but no later than 5 calendar days after ATRA therapy is initiated; consent can be obtained up till day 7 or earlier

• Co-management can be started as soon as referral is made including weekends; the physician at the outlying facility should make every effort to call the APL expert at the first suspicion of APL