The study analyzed 174 patients with newly diagnosed acute promyelocytic leukemia (APL) with a median follow-up of 59 months. During follow-up, early death occurred in 9 patients, relapse in 7 patients, and second primary malignancies in 7 patients. Early death was associated with severe hemorrhagic and thrombotic complications during induction therapy. Relapse was associated with additional adverse outcomes, including second primary malignancies and death. Study results support a tailored treatment approach that emphasizes rapid initiation of ATRA (all-trans retinoic acid) and intensive supportive care in patients with high-risk baseline features. They also recommend rigorous molecular monitoring and long-term follow-up of patients for early detection of relapse.