How Is Acute Lymphoblastic Leukemia Treated?

Acute lymphoblastic leukemia (ALL) treatment may include chemotherapy, targeted therapy, immunotherapy, and more. This may vary, depending on the person’s age and the condition’s severity. You and your doctor can determine the right treatment for you. Younger people with ALL usually undergo cancer therapy with fewer complications when compared with older adults. However, new clinical trials have become available, which may improve ALL outcomes for older adults.

This article reviews how doctors treat ALL, the treatment phases, and the treatments available for different age groups.

There are various treatment options for ALL. These options may include:

• chemotherapy
• radiation therapy
• immunotherapy
• stem cell transplant
• targeted therapy
• surgery

Your healthcare team can recommend the most effective therapy, depending on your overall health and the severity of ALL.

Chemotherapy is a type of cancer treatment that can kill cancer cells. This is the most common Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source treatment for ALL. It can also prevent the growth of new cancerous cells by stopping the division of the existing ones.

Doctors can give you chemotherapy intravenously, with a muscle injection, or orally. The medication will enter your bloodstream and reach the targeted area.

Healthcare professionals can also give you chemotherapy medications straight into your spinal fluid or target organs and any other body part needing cancer treatment.

Read more about chemotherapy.

Doctors utilize X-rays Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source and other types of radiation to target the areas that cancer affects. Radiation therapy can kill cancer cells and prevent their regrowth.

Healthcare professionals can treat people with ALL using radiation therapy to target cancer that has spread to their brain or spinal cord or to prevent this spread. They may also use radiation therapy as palliative therapy to improve the quality of life of people with cancer.

Read more about radiation therapy.

Doctors can give you substances made in a laboratory that your immune system can recognize and use to restore your body’s natural defense from cancer.

T cells are cell types that can kill Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source cancer cells. Your healthcare team can get T cells from your blood and modify and grow them in a laboratory before reintroducing them into your body via infusion. These new CAR T-cells can bind to cancer cells and kill them.

Read more about immunotherapy.

Targeted therapy focuses on specific parts of cancer cells. This therapy acts on more specific cancer cells and may sometimes work when chemotherapy treatment does not improve cancer on its own.

In about 25% Trusted Source American Cancer Society Highly respected international organization Go to source of people with ALL, leukemia cells have the “Philadelphia chromosome,” according to the American Cancer Society. The body accidentally creates this chromosome after chromosomes 9 and 22 swap genetic material with each other. Targeted therapy on the Philadelphia chromosome with chemotherapy can increase the chance of cancer remission.

Learn more about targeted therapy.

Stem cell transplants consist of Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source replacing the bone marrow of a person with ALL with compatible, healthy bone marrow from a donor. This may help produce new healthy blood cells.

However, stem cell transplants are gradually declining in popularity due to the continuous improvement of chemotherapy.

Read more about stem cell transplant.

In rare cases, doctors may recommend Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source a splenectomy. This procedure removes the spleen, and doctors perform it to help relieve symptoms related to abdominal discomfort from an enlarged spleen. Leukemia cells may gather in your spleen, and you may also experience an extremely low blood count.

However, removing the spleen does not generally change the outcome of ALL.

Learn more about splenectomy.

Treatment for ALL comprises three phases. The three phases of treatment include:

• Remission induction: During the first stage of ALL treatment, the therapy involves killing leukemia cells in your bone marrow, improving your symptoms, and restoring the balance of cells in your bloodstream.
• Consolidation: During the second phase of the therapy, doctors try to eliminate any remaining or residual cancer cells.
• Maintenance: During the last phase of the treatment, you can prevent cancer from returning by taking small doses of chemotherapy medications.

Read about acute lymphoblastic leukemia.

Treatment for ALL in children usually lasts about 2–3 years Trusted Source American Cancer Society Highly respected international organization Go to source . The most intense treatment period is typically in the first couple of months.

Doctors categorize Trusted Source American Cancer Society Highly respected international organization Go to source children into risk groups to ensure they receive the correct type and dose of treatment. To decide on a child’s risk group category, doctors review the following:

• age at ALL diagnosis
• gender
• initial white blood cell count
• ALL subtype
• chromosome changes
• number of chromosomes in the leukemia cells
• response to the initial treatment

About 20–30% of ALL cases and about half of ALL deaths occur in people more than 55 years old.

Unlike children and young adults, older adults may not be able to undergo aggressive therapy and often have other conditions that are incompatible with certain types of ALL treatment. However, leukemia in older adults can still have a positive outcome.

Your healthcare team may recommend the most effective treatment plan for your health conditions. This can include chemotherapy and immunotherapy. Doctors may also recommend older adults undergo alternative clinical trials if they believe intense chemotherapy treatment may not be the most effective treatment for their circumstances.

Discuss the treatment options that may be available for you with your doctor based on their effectiveness, side effects, and how they affect your quality of life. Your doctor can present you with the pros and cons of different therapies and trials so you can make an informed decision about your treatment plan.

It is important to know that the outlook of older adults with ALL is usually low. The 5-year relative survival rate of people older than 55 is about 10–20%. However, you can manage your ALL symptoms, and ALL can be treatable, increasing the quality of life and outlook for many.

Many new clinical trials have become available with positive results in recent years.

Chemotherapy is the main treatment for ALL. However, doctors may also recommend other therapies, such as immunotherapy and radiation therapy.

Children with ALL typically have a more positive outlook than older adults. If your doctor believes intensive chemotherapy treatments may not be the most effective treatment for you, they can recommend alternative therapy options.

Clinical trials are available, and they are improving the outcome of ALL for older people. Speak with your doctor about all the treatment options available to you.