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Treatment Option Overview

    Successful treatment of ALL consists of the control of bone marrow and systemic disease and the treatment (or prevention) of sanctuary-site disease, particularly the central nervous system (CNS).[1,2] The cornerstone of this strategy includes systemically administered combination chemotherapy with CNS preventive therapy. CNS prophylaxis is achieved with chemotherapy (intrathecal and/or high-dose systemic therapy) and, in some cases, cranial radiation therapy.

    Treatment is divided into the following three phases:

    • Remission induction.
    • CNS prophylaxis.
    • Postremission (also called remission continuation or maintenance).

    The average length of treatment for ALL varies between 1.5 and 3 years in the effort to eradicate the leukemic cell population. Younger adults with ALL may be eligible for selected clinical trials for childhood ALL. (Refer to the PDQ summary on Childhood Acute Lymphoblastic Leukemia Treatment for more information.)

    Entry into a clinical trial is highly desirable to assure adequate patient treatment and maximal information retrieval from the treatment of this highly responsive, but usually fatal, disease.

    Table 2. Standard Treatment Options for Adult ALL

    Disease StatusStandard Treatment Options
    CNS = central nervous system.
    Untreated ALLRemission induction therapy
    CNS prophylaxis therapy
    ALL in remissionPostremission therapy
    CNS prophylaxis therapy
    Recurrent ALLReinduction chemotherapy
    Palliative radiation therapy
    Dasatinib

    References:

    1. Clarkson BD, Gee T, Arlin ZA, et al.: Current status of treatment of acute leukemia in adults: an overview of the Memorial experience and review of literature. Crit Rev Oncol Hematol 4 (3): 221-48, 1986.
    2. Hoelzer D, Gale RP: Acute lymphoblastic leukemia in adults: recent progress, future directions. Semin Hematol 24 (1): 27-39, 1987.

      WebMD Public Information from the National Cancer Institute

      Last Updated: February 25, 2014
      This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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