Typical treatment of acute lymphocytic leukemia

For acute lymphocytic leukemia (ALL), chemotherapy (chemo) treatments are given in the phases described below. The total treatment usually takes about 2 years. Treatment may be more or less intense, depending on the subtype of ALL and other factors.

Remission induction: The purpose of the first phase is to bring about a remission. A remission means leukemia cells are no longer found in bone marrow samples, the normal marrow cells return, and the blood counts become normal. But a remission is not necessarily a cure, as leukemia cells may still be hiding somewhere in the body.

More than one chemo drug will be used and high doses will be given. The phase usually lasts for a month or so. Treatment to keep the leukemia cells from spreading to the central nervous system is often started at this time. This could include high-dose chemo, chemo put right into the spinal fluid, or radiation to the brain and spinal cord.

Treatment in this phase can often have serious side effects, including life-threatening infections. For this reason, the doctor will watch you closely and prescribe drugs like antibiotics if needed. You may need to spend some or much of this time in the hospital.

Consolidation: If the patient goes into remission, the next phase is often a fairly short course of chemo using high doses of many of the same drugs that were used before. This treatment phase lasts for a few months. Central nervous system treatment may be continued at this time.

Doctors may suggest a stem cell transplant (SCT) for patients who are at a high risk of relapse. Patients looking at a SCT might think about having it done as part of a clinical trial at a center that has done a lot of SCT procedures. Please see the section, "Bone marrow or peripheral blood stem cell transplant."

Maintenance: The last phase of treatment, called maintenance, is meant to help keep the leukemia from coming back. It uses lower doses of chemo drugs given over about 2 years. Central nervous system treatment may also be continued.