Acute Promyelocytic Leukemia: 37 Years Long Ongoing Survival in a de novo Patient with Metal-Based Ayurvedic Treatment

Abstract Acute promyelocytic leukemia (APML) is a subtype of acute myeloid leukemia. The condition is clinically marked by anemia, fatigue, weakness, frequent infections, and fever associated with easy bleeding and coagulopathy. The diagnosis is made through bone marrow aspiration exhibiting increased promyelocytes and test for PML-RARα fusion gene. There has been remarkable progress in the treatment of APML in the past few decades with the induction of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). This has also brought down mortality and relapse rates considerably. Similarly, nearly 90% patients are able to live disease free for about 10 years. However, there are certain hindrances to these treatments majorly due to side effects, relapses, and limited periods of remission associated with ATRA and ATO. Here, a freshly diagnosed case of APML is being reported. The patient was diagnosed in leading medical centers of Aligarh and New Delhi and only treated with blood transfusions in the absence of an established line of treatment in 1982. The patient has completed 37 years long survival without any sign of the disease and any adverse effect. This approach could be considered as an add-on medical therapy for APML.