Treatments for acute lymphoblastic leukemia
Your healthcare team will create a treatment plan just for you. The plan is based on your health and specific information about the cancer. What you want is also important when planning treatment. When deciding which treatments to offer for acute lymphoblastic leukemia (ALL), your healthcare team will consider:
- your age
- chromosome or gene changes (also called abnormalities)
- the subtype (or classification) of ALL
- your overall health
- risk group
- possible side effects of treatment
- hormone status
- your initial
white blood cellcount
- how the cancer responds to treatment
- if the cancer has come back (relapsed or recurred) or spread to the brain and spinal cord (called the
central nervous system, or CNS)
Chemotherapy is the main treatment for ALL. Targeted therapy and radiation therapy are sometimes used to treat ALL as well.
If ALL relapses or doesn't respond to treatment (called refractory ALL), immunotherapy including
It is important to start treatment as soon as ALL is diagnosed. If the cancer recurs, your lifestyle and preferences can help plan further treatment.
Treatment for ALL is different for adults than it is for children. Find out more about treatments for childhood ALL.
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Knowing how well leukemia responds to treatment helps doctors determine your prognosis and plan future care. The goal of treatment is to reach a complete remission.
Complete remission, or complete response, means that the numbers of blood cells (red blood cells, white blood cells and platelets) have returned to normal levels and less than 5% of cells in the bone marrow are immature white blood cells (also called leukemia cells, blast cells or blasts). With a complete remission, there are no general signs or symptoms of ALL and no signs or symptoms that ALL has spread to the CNS or anywhere else in the body.
Minimal residual disease (MRD) means that there are leukemia cells in the bone marrow, but they can only be seen using sensitive tests, such as flow cytometry or polymerase chain reaction (PCR). The leukemia cells can’t be seen with standard tests, such as looking at the cells under a microscope.
Active disease means that leukemia cells are still present during treatment or that the disease comes back (relapses) after treatment. With active disease, more than 5% of cells in the bone marrow are leukemia cells.
Expert review and references
Kareem Jamani, MD, LMCC, FRCPC
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American Cancer Society . Treating Acute Lymphocytic Leukemia (ALL) . 2021 : https://www.cancer.org/.
Kebriaei P, Ravandi F, de Lima M, Champlin R. Management of acute leukemias. DeVita VT Jr., Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 11th ed. Philadelphia, PA: Wolters Kluwer; 2019: 102:1742–1763..
American Society of Clinical Oncology (ASCO) . Cancer.net: Leukemia - Acute Lymphocytic - ALL. 2017 : https://www.cancer.net/.
National Comprehensive Cancer Network . NCCN Guidelines for Patients: Acute Lymphoblastic Leukemia . 2021 : https://www.nccn.org/.
PDQ® Adult Treatment Editorial Board. Adult Acute Lymphoblastic Leukemia Treatment(PDQ®) – Patient Version. Bethesda, MD: National Cancer Institute; 2021: https://www.cancer.gov/.
PDQ® Adult Treatment Editorial Board. Adult Acute Lymphoblastic Leukemia Treatment (PDQ®) – Health Professional Version. Bethesda, MD: National Cancer Institute; 2021: https://www.cancer.gov/.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Acute Lymphoblastic Leukemia (Version 2.2021) . 2021: https://www.nccn.org/home.
Seiter K. Medscape Reference: Acute Lymphoblastic Leukemia (ALL) Treatment & Management. New York, NY: WebMD LLC; 2021: https://www.medscape.com/.