The International Consortium on Acute Promyelocytic Leukemia (IC-APL), later renamed as International Consortium on Acute Leukemias (ICAL), was founded in 2004 as an initiative of the International Members Committee of the American Society of Hematology (ASH). Its goal was to create a network of institutions in developing countries that would exchange experience and data and receive support from well-established cooperative groups, bringing together clinical investigators from Europe, North America and Latin America. The Consortium selected acute promyelocytic leukaemia (APL) as a model disease to test the impact of networking on the outcome of patients treated in developing countries, because it is a highly curable disease, if early diagnosis and specific treatment are promptly established. By the end of the 1990's, European and American groups reported complete remission (CR) and long-term disease-free survival (DFS) rates of approximately 90% and 85%, respectively, in studies of cohorts of APL patients who were treated with all trans retinoic acid (ATRA) and anthracyclines (Soignet et al., 1997; Sanz et al., 1999). In contrast, a retrospective analysis of 134 Brazilians patients with APL treated between 2003 and 2006 reported a death rate of 32% during induction, with most of the deaths caused by APL-associated coagulopathy (Jacomo et al., 2007). In this study the long-term overall survival (OS) rate at 2 years was less than 60%, indicating a clearly unmet medical need. The consortium adopted the combination of ATRA and anthracycline, using the same design of the PETHEMA/HOVON LPA2005 protocol (Sanz et al., 2010, 2015), except that idarubicin was replaced by daunorubicin at a ratio of 1:5. Importantly, medical educational activities, centralized laboratory diagnosis and monitoring and specific guidelines for supportive treatment were adopted. Here we will present the analysis of 306 Brazilian patients treated according to the IC-APL protocol and discuss the achievements and pitfalls that the group has faced during its 16-year experience. In total Number of screened patients: 374 patients were screened and 306 were considered elegible with an average of 25.4pts/year. The main reasons of ineligibility were PML/RARA was not detected (36%); previous chemo or radiotherapy (12%), drug unavailability (10%); age >75y (8%); pregnancy (7%). One case of ZBTB16/RARA rearrangement was detected. The median time of follow up was of 50 months. The Complete Hematological Remission was of 88.9% and the number of deaths during induction among eligible patients was of 33 (10.7%). The Cummulative Incidence of Relapse was 13% (35/265pts) and most relapses occurred during maintenance relapse (21 pts). Monitoring was successfully performed by RT-qPCR and conventional RT-PCR. With discrepant results in only 7 patients (in whom relapse was first detected by RT-qPCR). The 10-year overall survival rate was of 75% (95% CI: 68–80%) and the 10-year disease free survival was of 82% (95% CI: 75–87). The ICAL experience confirmed that the establishment of clinical networks involving developing and developed countries may be a powerful strategy to face the challenges faced by hematologists treating acute leukemias in the developing world.