AUTHOR=Gao Lu , An Yang , Li Qian , Shi Shuo , Zhou Jie , Du Zuochen , Huang Pei , Ren Mingqiang , Chen Yan 

TITLE=Ultra-late relapse of acute promyelocytic leukemia 18 years after complete remission: a case report and literature review

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1651742

DOI=10.3389/fmed.2025.1651742

ISSN=2296-858X

ABSTRACT=Late relapse of acute promyelocytic leukemia (APL) is associated with high mortality rates. While APL typically shows a low incidence of relapse after achieving complete remission (CR) for more than 7 years, we report a rare case of APL relapse occurring 18 years after CR was achieved. The patient was successfully treated with a combination of arsenic trioxide (ATO) and all-trans retinoic acid (ATRA), leading to favorable outcomes. Additionally, we review our treatment experience and provide a comprehensive analysis of the existing literature, summarizing the characteristics of reported APL cases that relapsed after maintaining CR for over 7 years.