{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T05:51:20Z","timestamp":1774763480935,"version":"3.50.1"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>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\u202fyears, we report a rare case of APL relapse occurring 18\u202fyears 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\u202fyears.<\/jats:p>","DOI":"10.3389\/fmed.2025.1651742","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T04:13:32Z","timestamp":1757909612000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Ultra-late relapse of acute promyelocytic leukemia 18\u202fyears after complete remission: a case report and literature review"],"prefix":"10.3389","volume":"12","author":[{"given":"Lu","family":"Gao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"An","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuo","family":"Shi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zuochen","family":"Du","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingqiang","family":"Ren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1630","DOI":"10.1182\/blood-2019-01-894980","article-title":"Management of acute promyelocytic leukemia: updated recommendations from an expert panel of the European LeukemiaNet","volume":"133","author":"Sanz","year":"2019","journal-title":"Blood"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"4298","DOI":"10.1182\/blood-2002-02-0632","article-title":"All-trans retinoic acid in acute promyelocytic leukemia: long-term outcome and prognostic factor analysis from the north American intergroup protocol","volume":"100","author":"Tallman","year":"2002","journal-title":"Blood"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1007\/s12185-017-2318-x","article-title":"JSH guideline for tumors of hematopoietic and lymphoid tissues: leukemia: 2. 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