In general, treatment for acute lymphocytic leukemia falls into separate phases:
- Phase 1: Induction therapy to kill most of the leukemia cells in the blood and bone marrow and to restore normal blood cell production.
- Phase 2: Consolidation therapy (post-remission therapy) aimed at destroying any remaining leukemia in the body.
- Phase 3: Maintenance therapy to prevent leukemia cells from regrowing.
- Phase 4: Preventive treatment to the spinal cord, an additional treatment to kill leukemia cells located in the central nervous system. In this type of treatment, chemotherapy drugs are often injected
The main treatment options for acute lymphoblastic leukemia (ALL) include chemotherapy, targeted therapy, and stem cell transplant among others. These are explained below.
Chemotherapy: This is the primary treatment for ALL and involves the use of drugs to kill cancer cells. Chemotherapy can be administered orally or intravenously and may be given in cycles over a period of several months.
Targeted therapy: Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die. Your leukemia cells will be tested to see if targeted therapy may be helpful for you. Targeted therapy can be used alone or in combination with chemotherapy for induction therapy, consolidation therapy or maintenance therapy.
Radiation therapy: Radiation therapy uses high-powered beams, such as X-rays or protons, to kill cancer cells. If the cancer cells have spread to the central nervous system, your doctor may recommend radiation therapy.
Stem cell transplant: A stem cell transplant, also known as a bone marrow transplant, is a treatment option for patients with ALL who have not responded to chemotherapy or who have a high risk of relapse. It involves replacing the patient’s diseased bone marrow with healthy bone marrow from a donor. A bone marrow transplant begins with high doses of chemotherapy or radiation to destroy any leukemia-producing bone marrow. The marrow is then replaced by bone marrow from a compatible donor (allogeneic transplant).
Engineering immune cells to fight leukemia: A specialized treatment called chimeric antigen receptor (CAR)-T cell therapy takes your body’s germ-fighting T cells, engineers them to fight cancer and infuses them back into your body.CAR-T cell therapy might be an option for children and young adults. It might be used for consolidation therapy or for treating relapse.
Clinical trials. Clinical trials are experiments to test new cancer treatments and new ways of using existing treatments. While clinical trials give you or your child a chance to try the latest cancer treatment, the benefits and risks of the treatment may be uncertain. Discuss the benefits and risks of clinical trials with your doctor.
In addition to these treatments, patients with ALL may also receive supportive care to manage side effects and improve their quality of life. This may include:
- medications to control nausea and vomiting
- blood transfusions
- interventions to manage infections or bleeding.
Alternative medicine
No alternative treatments have been proved to cure acute lymphocytic leukemia. But some alternative therapies may help ease the side effects of cancer treatment and make you or your child more comfortable. Discuss your options with your doctor, as some alternative treatments could interfere with cancer treatments, such as chemotherapy.
Alternative treatments that may ease symptoms include:
- Acupuncture
- Exercise
- Massage
- Meditation
- Relaxation activities, including yoga and tai chi
It’s important to note that the treatment plan for ALL will be tailored to the individual patient and may involve a combination of the above treatments. It’s important to discuss all treatment options with a healthcare professional to determine the best approach for the individual patient.