Acute Lymphoblastic Leukemia
Symptoms of Acute Lymphoblastic Leukemia
Treatment for Acute Lymphoblastic Leukemia
ALL is really a group of related diseases, or subtypes. Therefore, your treatment options depend upon your subtype and other factors. You may have more than one type of treatment. These include:
Chemotherapy, the use of anticancer drugs in combination, generally over a couple of years. Agents used for ALL include:
Targeted therapy, drugs that target specific parts of cancer cells and tend to have fewer or less severe side effects than chemotherapy; examples include imatinib (Gleevec), dasatinib (Sprycel), blinatumomab (Blincyto), ponatinib (Iclusig), and nilotinib (Tasigna), which attack cells with the Philadelphia chromosome.
Radiation therapy, the use of high-energy radiation to kill cancer cells; this is not used often for ALL, but may be used to treat leukemia in the brain or bone, for example, or before a stem cell transplant.
A bone marrow transplant, which involves use of high doses of chemotherapy and possibly radiation followed by a transplant of bone-forming stem cells; stem cells usually come from a donor, or less likely, from your own bone marrow or peripheral blood. If you cannot tolerate high doses of chemotherapy and radiation, lower doses may be used with a "mini-transplant."
Treatment occurs in two parts -- induction therapy and post-induction therapy.
The goal of induction therapy is to achieve remission by:
- Killing as many leukemia cells as possible
- Returning blood counts to normal
- Ridding the body of signs of disease for a long time
About eight or nine out of 10 adults achieve remission after treatments, but many relapse, which lowers the overall cure rate to 30% to 40%. So even with remission, post-induction therapy is needed to prevent relapse. It involves cycles of treatment over two to three years. Usually, the drugs are different than the drugs used in induction therapy. The goal is to completely rid the body of leukemia cells that have not been found by common blood or marrow tests.