Remission in cases of high-risk APL is still difficult to achieve, and relapses occur readily.<h4>Case report:</h4>Here, we describe a case of APL with high white blood cell counts in blood tests and hypogranular variant morphology in bone marrow, together with fms-like tyrosine kinase-3 with internal tandem duplication mutations (FLT3-ITD), and bcr-3 isoform of PML-RARα. The gene discussed is FLT3; the disease is acute promyelocytic leukemia.