Moreover, a retrospective analysis of 651 AML patients conducted by Wang et al[10] found fewer favorable genetic molecular events in elderly patients with AML and secondary AML patients, such as a CEBPA double mutation, runx1-runxt1t1, etc. A double mutation to the CEBPA gene is detected in leukemia cells during AML transformation, and some cases before transformation to APL were accompanied with a double mutation to the CEBPA gene.[11] However, our patient was negative for the CEBPA double mutation at the first onset, which does not support the possibility of evolution from APL to AML. This evidence concerns the gene RUNX1 and acute promyelocytic leukemia.