Treatment overview

The aim of treatment for ALL is to get rid of the leukaemia cells and allow the bone marrow to work normally again. This is called remission.

While doctors are planning your treatment, you will usually be given steroids to start getting rid of leukaemia cells.

Chemotherapy is the main treatment for ALL. Some people may also have a stem cell transplant or targeted therapies.

Treatment for ALL usually takes about 2 to 3 years to complete. If the ALL comes back (relapses) after treatment, it can often be treated again to get a second remission. When a person stays in remission, they are said to be cured.

Treatment for ALL can affect your fertility. Before treatment, your doctors and nurses will explain whether anything can be done to help preserve your fertility.

You’ll be given treatment in a specialist cancer centre. Some hospitals also have specially-designed teenage and young adult cancer units.

Treatment for acute lymphoblastic leukaemia

The main treatment for ALL is chemotherapy. Other treatments that may be used include targeted therapy and a stem cell transplant. Your course of treatment will depend on the type of ALL you have and how it responds to treatment.

The aim of treatment for ALL is to get rid of the leukaemia cells and allow the bone marrow to work normally again. This is called remission.

After treatment, doctors use blood and bone marrow tests to check if you are in remission. If the tests can’t find any leukaemia cells the doctor will say you are in remission.

Sometimes small amounts of leukaemia cells may still be in your body after you are in remission. This is called minimal residual disease (MRD). MRD can’t be seen using standard tests so doctors use more sensitive tests. The main test used is the polymerase chain reaction (PCR) test. Another test called immunophenotyping may also be used. We have more information about these tests.

You will have tests for MRD during and after your treatment. The results of these tests help doctors:

  • make decisions about your treatment
  • see how well your treatment has worked
  • see if your leukaemia is more likely to come back.


Steroids before treatment

When you are first diagnosed your doctors will often give you steroids. These start getting rid of leukaemia cells while the doctors plan your treatment. Usually this only takes a few days.


Chemotherapy

There are three main phases of chemotherapy:

  • Induction – the first phase of chemotherapy. It is given to get you into remission.
  • Intensification – the next phase. It is given to stop the leukaemia coming back.
  • Maintenance – the last phase of treatment. It is given to keep the leukaemia away long-term.


Targeted therapies

Targeted therapies are drugs designed to identify and attack cancer cells. They work by ‘targeting’ specific proteins on or in the leukaemia cells. If you have Philadelphia positive ALL you will usually be treated with a targeted therapy and chemotherapy.

The targeted therapy is a tablet called imatinib (Glivec®). It targets the effects of the Philadelphia chromosome.


Stem cell transplant

Some people may need a donor stem cell transplant. This is where stem cells from someone else (a donor) are given to you to treat the leukaemia.


Clinical trials for ALL

Most people in the UK have treatment for ALL as part of large national and international clinical trials. Doctors use drugs and treatments for ALL that are known to work well. But they may give them in different combinations. Or they may test newer types of drugs alongside current treatments. We also have general information about research and trials.


Having treatment

Treatment for ALL usually takes about 2 to 3 years to complete. This may sound like a long time, but most of the treatment can be given as an outpatient.

If the ALL comes back (relapses) after treatment it may be possible to have more treatment. A second remission may be possible. When remission lasts indefinitely the person is said to be cured.


Fertility

Treatment for ALL may cause temporary or permanent infertility. This is more likely if you have a stem cell transplant. Before your treatment starts, your doctor and nurses will discuss fertility with you. They will explain what may be done to help preserve your fertility.


Where treatment is given

You will usually have your treatment in a cancer centre. These centres give specialist treatments, such as chemotherapy and stem cell transplants. They are usually based at larger hospitals so you may have to travel to have your treatment and see your haematologist.

Teenagers and young adults

Some hospitals have specially-designed teenage and young adult cancer units (sometimes called TYA units). These units mean you can have your treatment alongside other young people. They are not available at every hospital so you may have to travel further from home to have treatment at a TYA unit. Other hospitals may have special wards or areas for you if you’re a teenager with cancer. There may be computer games, DVDs and music to help you feel more at home. You may have access to a computer so that you can do some of your school or college work if you feel well enough. There may also be education specialists who can stay in touch with your school or college and support your learning needs while you’re having treatment.

In some hospitals there isn’t a special ward for teenagers with cancer. Or you may choose to be treated at a hospital closer to home. In this situation you may be treated on an adult cancer ward. The staff on the adult cancer ward will still be able to look after your needs, although the facilities may not be the same as those on a unit specially designed for teenagers.

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