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Treatment options

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multi disciplinary team (MDT).

Your MDT might include:

  • blood cancer specialists called consultant haematologists
  • haematology nurse specialists, also called clinical nurse specialists (CNS)
  • dietitians
  • doctors specialising in reporting bone marrow or lymph node biopsies (haemopathologists)
  • doctors specialising in reporting x-rays and scans (radiologists)
  • doctors specialising in diagnosing and controlling infection (microbiologists)
  • social workers
  • symptom control specialists called palliative care doctors and nurses
  • pharmacists

Your MDT will discuss your treatment, its benefits and the possible side effects with you. Your treatment will depend on:

  • the type of leukaemia you have
  • your age, general health and level of fitness
  • if you have gene changes (mutations) in the leukaemia cells

The main treatments for ALL

Most people with ALL start treatment quickly after diagnosis. The main treatment is chemotherapy. 

Apart from chemotherapy other treatments for ALL include:

  • steroids
  • targeted cancer drugs
  • radiotherapy
  • growth factors
  • stem cell or bone marrow transplants

Other treatment

You might need other treatments to support you while you have your main leukaemia treatment. This might be because you have an infection or to help with the side effects of treatment. These include:

  • anti sickness medicines
  • painkillers
  • blood or platelet transfusions
  • medicines to protect your kidneys
  • antibiotics
  • fluid through a drip to keep you hydrated

Phases of treatment

Doctors divide treatment for ALL into 3 different phases. The treatment usually takes 2 to 3 years altogether. The maintenance therapy phase takes up most of this time.

Getting rid of ALL (remission induction)

The aim of the induction phase is to destroy the leukaemia cells. This is called complete remission (CR). It means there is no sign of the leukaemia in your blood or bone marrow.

The main treatment is chemotherapy. If you have Philadelphia positive ALL you also have a targeted cancer drug called imatinib.

Treatment to stop ALL coming back (consolidation or intensification therapy)

Consolidation therapy is when the treatment is made stronger. The aim is to get rid of any leukaemia cells that might still be there and to stop it from coming back. You might have:

  • more chemotherapy
  • a transplant using stem cells from someone else (donor)
  • a transplant with your own blood stem cells, but this is rare

Keeping ALL away long term (maintenance therapy)

The last phase of ALL treatment is maintenance therapy. It helps to keep the leukaemia in remission. This is usually chemotherapy and short courses of steroids.

Treating ALL that comes back or resists treatment

Sometimes tests still find leukaemia cells in the bone marrow while you’re having treatment. This means the leukaemia isn’t responding to the drugs you’re having. It’s called resistant or refractory leukaemia.

Your doctor may recommend you have:

  • more chemotherapy using different drugs 
  • a targeted cancer drug
  • treatment as part of a clinical trial 

Leukaemia that comes back after treatment is called relapsed leukaemia. Treatment depends on:

  • certain features of the leukaemia cells
  • how long you were in remission
  • your age, general health and level of fitness
  • what treatment you had before

Your doctor may recommend you have:

•   chemotherapy
•   a targeted cancer drug 
•   taking part in a clinical trial
•   a stem cell transplant

Clinical trials

You often have treatment for ALL as part of a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments.

Last reviewed: 
10 May 2018
  • Acute lymphoblastic leukaemia in adult patients: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow up
    D Hoezler and others
    Annals of Oncology, 2016. Volume 27, Supplement 5, Pages 69-82

  • Hoffbrand’s Essential Haematology (7th Edition)
    AV Hoffbrand and PAH Moss
    Wiley Blackwell, 2016

  • Cancer and its management (7th edition)
    J Tobias and D Hochhauser
    Wiley-Blackwell, 2015

  • Oxford handbook of clinical medicine (10th edition)
    M Longmore, IB Wilkinson, A Baldwin and E Wallin
    Oxford University Press, 2017

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