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http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page1

General Information About Childhood Acute Lymphoblastic Leukemia

Key Points for This Section

Childhood acute lymphoblastic leukemia (ALL) is a type of cancer in which the bone marrow

makes too many immature lymphocytes (a type of white blood cell).

Family history and being exposed to radiation may affect the risk of developing childhood

ALL.

Possible signs of childhood ALL include fever and bruising.

Tests that examine the blood and bone marrow are used to detect (find) and diagnose

childhood ALL.

Certain factors affect prognosis (chance of recovery) and treatment options.

Childhood acute lymphoblastic leukemia (ALL) is a type of cancer in which the bone marrow makes

too many immature lymphocytes (a type of white blood cell).

Childhoodacute lymphoblastic leukemia(also called acute lymphocytic leukemia or ALL) is

acancerof thebloodandbone marrow.This type of cancer usually gets worse quickly if it is not

treated.

ALL is the most common type of cancer in children.

In a healthy child, the bone marrow makes bloodstem cells(immaturecells)that become mature

blood cells over time. A blood stem cell may become amyeloidstem cell or alymphoidstem cell.

A myeloid stem cell becomes one of three types of mature blood cells:

Red blood cellsthat carryoxygenand other substances to alltissuesof the body.

Plateletsthat formblood clotsto stop bleeding.

White blood cellsthat fightinfectionand disease.

A lymphoid stem cell becomes alymphoblastcell and then one of three types oflymphocytes(white

blood cells):

B lymphocytesthat makeantibodiesto help fight infection.

T lymphocytesthat help B lymphocytes make the antibodies that help fight infection.
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ommon/PopUps/popDefinition.aspx?id=476017&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=476017&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45993&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45993&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45364&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45364&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45364&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=302475&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=302475&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=302475&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45765&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45765&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45765&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44953&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44953&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44918&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44918&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44918&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44928&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44928&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44928&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44918&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44953&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45765&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=302475&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45364&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45993&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=476017&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45840&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46683&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=538149&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46124&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46298&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46279&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46476&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46598&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45622&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=270735&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45333&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45586&version=Patient&language=Englishhttp://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page1#Keypoint5http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page1#Keypoint4http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page1#Keypoint4http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page1#Keypoint3http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page1#Keypoint2http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page1#Keypoint2http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page1#Keypoint1http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page1#Keypoint1http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page1


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Natural killer cellsthat attack cancer cells andviruses.

Enlarge

Blood cell development. A blood stem cell goes through several steps to become a red blood cell,

platelet, or white blood cell.

In a child with ALL, too many stem cells become lymphoblasts, B lymphocytes, or T lymphocytes.

These cells are cancer (leukemia)cells. The leukemia cells do not work like normal lymphocytes and

are not able to fight infection very well. Also, as the number of leukemia cells increases in the blood

and bone marrow, there is less room for healthy white blood cells, red blood cells, and platelets. This

may lead to infection,anemia,and easy bleeding.

This summary is about acute lymphoblastic leukemia in children, teenagers, and young adults. See

the followingPDQsummaries for information about other types of leukemia:

Childhood Acute Myeloid Leukemia/Other Myeloid Malignancies Treatment

Adult Acute Lymphoblastic Leukemia Treatment

Chronic Lymphocytic Leukemia Treatment

Adult Acute Myeloid Leukemia Treatment

Chronic Myelogenous Leukemia Treatment

Hairy Cell Leukemia Treatment
http://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44062&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44062&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45941&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45941&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45941&version=Patient&language=Englishhttp://www.cancer.gov/PublishedContent/MediaLinks/555629.htmlhttp://www.cancer.gov/PublishedContent/MediaLinks/555629.htmlhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45343&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45343&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45343&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45360&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45360&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45360&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44271&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44271&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44271&version=Patient&language=Englishhttp://www.cancer.gov/cancertopics/pdq/treatment/childAML/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/childAML/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/adultALL/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/adultALL/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/CLL/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/CLL/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/adultAML/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/adultAML/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/CML/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/CML/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/hairy-cell-leukemia/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/hairy-cell-leukemia/Patienthttp://www.cancer.gov/PublishedContent/MediaLinks/555629.htmlhttp://www.cancer.gov/cancertopics/pdq/treatment/hairy-cell-leukemia/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/CML/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/adultAML/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/CLL/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/adultALL/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/childAML/Patienthttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44271&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45360&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45343&version=Patient&language=Englishhttp://www.cancer.gov/PublishedContent/MediaLinks/555629.htmlhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45941&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44062&version=Patient&language=English


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Family history and being exposed to radiation may affect the risk of developing childhood ALL.

Anything that increases your risk of getting a disease is called arisk factor.Having a risk factor does

not mean that you will get cancer; not having risk factors doesnt mean that you will not get cancer.

Talk with your child's doctor if you think your child may be at risk. Possible risk factors for ALL

include the following:

Being exposed tox-raysbefore birth.

Being exposed toradiation.

Past treatment withchemotherapy.

Having certain changes in thegenes.

Having certaingeneticconditionsthat include the following:

o

Down syndrome.

o Ataxia-telangiectasia.

o Bloom syndrome.

o Neurofibromatosis.

o Shwachman syndrome.

Possible signs of childhood ALL include fever and bruising.

These and othersymptomsmay be caused by childhood ALL. Other conditions may cause the same

symptoms. Check with your child's doctor if your child has any of the following problems:

Fever.

Easy bruising or bleeding.

Petechiae(flat, pinpoint, dark-red spots under the skin caused by bleeding).

Bone orjointpain.

Painless lumps in the neck, underarm,stomach,orgroin.

Pain or feeling of fullness below the ribs.

Weakness, feeling tired, or looking pale.

Loss ofappetite.

Tests that examine the blood and bone marrow are used to detect (find) and diagnose childhood

ALL.

The following tests and procedures may be used:
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guage=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=450108&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45022&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=644775&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=666662&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=270853&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45488&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=651193&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=444994&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45693&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45214&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45072&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45944&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45873&version=Patient&language=English


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Physical examandhistory: An exam of the body to check general signs of health, including

checking for signs of disease, such as lumps or anything else that seems unusual. A history of

the patient's health habits and past illnesses and treatments will also be taken.

Complete blood count (CBC) with differential: A procedure in which a sample of blood is

drawn and checked for the following:

The number of red blood cells and platelets.

The number and type of white blood cells.

The amount ofhemoglobin(theproteinthat carries oxygen) in the red blood cells.

The portion of the sample made up of red blood cells.

Enlarge

Complete blood count (CBC). Blood is collected by inserting a needle into a vein and allowing the

blood to flow into a tube. The blood sample is sent to the laboratory and the red blood cells, white

blood cells, and platelets are counted. The CBC is used to test for, diagnose, and monitor many

different conditions.

Bone marrow aspirationandbiopsy: The removal of bone marrow, blood, and a small piece

of bone by inserting a hollow needle into the hipbone orbreastbone.Apathologistviews the

bone marrow, blood, and bone under amicroscopeto look for signs of cancer.
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Bone marrow aspiration and biopsy. After a small area of skin is numbed, a Jamshidi needle (a long,

hollow needle) is inserted into the patients hip bone. Samples of blood, bone, and bone marrow are

removed for examination under a microscope.

Cytogenetic analysis: Alaboratory testin which the cells in a sample of blood or bone

marrow are viewed under a microscope to look for certain changes in the chromosomes in

the lymphocytes. For example, in Philadelphia chromosome-positive ALL, part of one

chromosome is moved to another chromosome. This is called the Philadelphia

chromosome. Other tests, such asfluorescence in situ hybridization(FISH), may also be

done to look for certain changes in the chromosomes.
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Philadelphia chromosome. A piece of chromosome 9 and a piece of chromosome 22 break off and

trade places. The bcr-abl gene is formed on chromosome 22 where the piece of chromosome 9

attaches. The changed chromosome 22 is called the Philadelphia chromosome.

Immunophenotyping: A test in which the cells in a sample of blood or bone marrow are

looked at under a microscope to find out ifmalignantlymphocytes (cancer) began from the

B lymphocytes or the T lymphocytes.

Blood chemistry studies: A procedure in which a blood sample is checked to measure the

amounts of certain substances released into the blood byorgansand tissues in the body. An

unusual (higher or lower than normal) amount of a substance can be a sign of disease in the

organ or tissue that makes it.

Chest x-ray: Anx-rayof the organs and bones inside the chest. An x-ray is a type of energybeam that can go through the body and onto film, making a picture of areas inside the body.

Certain factors affect prognosis (chance of recovery) and treatment options.

Theprognosis(chance ofrecovery)depends on:

Age atdiagnosis,gender, and race.

The number of white blood cells at diagnosis.

Whether the leukemia cells began from B lymphocytes or T lymphocytes.

Whether there are certain changes in the chromosomes of lymphocytes.
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Whether the child has Down syndrome.

Whether the leukemia has spread to the brain,spinal cord,ortesticles.

How quickly and how low the leukemia cell count drops after initial treatment.

The treatment options depend on:

Whether the leukemia cells began from B lymphocytes or T lymphocytes.

Whether the child has standard-risk or high-risk ALL.

The age of the child at diagnosis.

Whether there are certain changes in the chromosomes of lymphocytes, such as the

Philadelphia chromosome.

For leukemia thatrecurs(comes back) after initial treatment, the prognosis and treatment optionsdepend on:

How long it is between the end of initial treatment and when the leukemia recurs.

Whether the leukemia recurs in the bone marrow or outside the bone marrow.

Risk Groups for Childhood Acute Lymphoblastic Leukemia


Once childhood ALL has been diagnosed, tests are done to find out if the cancer has spreadto the brain, spinal cord, testicles, or to other parts of the body.

There are three ways that cancer spreads in the body.

In childhood ALL, risk groups are used to plan treatment.

Once childhood ALL has been diagnosed, tests are done to find out if the cancer has spread to the

brain, spinal cord, testicles, or to other parts of the body.

The following tests and procedures may be used to find out if the cancer has spread:

Lumbar puncture: A procedure used to collectcerebrospinal fluidfrom thespinal column.

This is done by placing a needle into the spinal column. This procedure is also called an LP or

spinal tap.

Chest x-ray: Anx-rayof theorgansand bones inside the chest. An x-ray is a type of energy

beam that can go through the body and onto film, making a picture of areas inside the body.

The chest x-ray is done to see ifleukemiacellsare forming amassin the middle of the chest.
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atient/page2#Keypoint6http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page2#Keypoint6http://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46556&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46611&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=340937&version=Patient&language=English


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Testicularbiopsy: The removal of cells ortissuesfrom the testicles so they can be viewed

under amicroscopeby apathologistto check for signs of cancer. This procedure is done only

if there seems to be anything unusual about the testicles during thephysical exam.

There are three ways that cancer spreads in the body.

When cancercellsspread outside theblood,asolid tumormay form. This process is

calledmetastasis.The three ways that cancer cells spread in the body are:

Through the blood. Cancer cells travel through the blood,invadesolidtissuesin the body,

such as the brain or heart, and form a solid tumor.

Through thelymph system.Cancer cells invade the lymph system, travel through thelymph

vessels,and form a solid tumor in other parts of the body.

Through solid tissue. Cancer cells that have formed a solid tumor spread to tissues in the

surrounding area.

The new (metastatic)tumor is the same type of cancer as theprimary cancer.For example,

ifleukemiacells spread to the brain, the cancer cells in the brain are actually leukemia cells. The

disease is metastatic leukemia, not brain cancer.

In childhood ALL, risk groups are used to plan treatment.

Risk groupsare described as:

Standard (low) risk: Includes children aged 1 to younger than 10 years who have awhite

blood cellcount of less than 50,000/L atdiagnosis.

High risk: Includes children younger than 1 year or 10 years and older and children who have

a white blood cell count of 50,000/L or more at diagnosis.

Other factors that affect the risk group include the following:

Whether the leukemia cells formed fromB lymphocytesorT lymphocytes.

Whether there are certain changes in thechromosomesof thelymphocytes.

How quickly the leukemia responds to initialtherapy.

Whether the leukemia has spread to the brain,spinal cord,testicles, or other parts of the

body.

It is important to know the risk group in order to plan treatment. Children with high-risk ALL usually

receive moreaggressivetreatment than children with standard-risk ALL.

Recurrent Childhood Acute Lymphoblastic Leukemia

RecurrentchildhoodALLiscancerthat hasrecurred(come back) after it has been treated.

Theleukemiamay come back in thebloodandbone marrow,brain,spinal cord,testicles,or other

parts of the body.
http://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46611&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45164&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45164&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45164&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46683&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46683&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46683&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=638184&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=638184&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=638184&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46244&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46244&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46244&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=270871&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=270871&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=270871&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46476&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46476&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46476&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=270735&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=270735&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=270735&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45301&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45301&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45301&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46710&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46710&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46710&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45741&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45741&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45741&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46683&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46683&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46683&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45764&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45764&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45764&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=269462&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=269462&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=269462&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=269462&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44058&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44058&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44058&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45847&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45847&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45847&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45343&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45343&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45343&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=693559&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=693559&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45993&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45993&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45993&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45993&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46450&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46450&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46450&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44953&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44953&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44953&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=467345&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=467345&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=467345&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46470&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46470&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46470&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45765&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45765&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45765&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44737&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44737&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44737&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=340937&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=340937&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=340937&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46053&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46053&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46053&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45862&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45862&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44362&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44362&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44362&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45333&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45333&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45333&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46556&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46556&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46556&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45343&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45343&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=270735&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=270735&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=270735&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45622&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45622&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45622&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=340937&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=340937&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=340937&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46611&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46611&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46611&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46611&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=340937&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45622&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=270735&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45343&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46556&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45333&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44362&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45862&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46053&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=340937&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44737&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45765&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46470&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=467345&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44953&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46450&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45993&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45993&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=693559&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45343&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45847&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44058&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=269462&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=269462&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45764&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46683&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45741&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46710&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45301&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=270735&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46476&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=270871&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46244&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=638184&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46683&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45164&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46611&version=Patient&language=English


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Treatment Option Overview


There are different types of treatment for childhood acute lymphoblastic leukemia (ALL).

Children with ALL should have their treatment planned by a team of doctors with expertise

in treating childhood leukemia.

The treatment of childhood ALL usually has three phases.

Four types of standard treatment are used:

o Chemotherapy

o Radiation therapy

o

Chemotherapy with stem cell transplant

o Targeted therapy

Treatment is given to kill leukemia cells that have spread or may spread to the brain, spinal

cord, or testicles.

New types of treatment are being tested in clinical trials.

Patients may want to think about taking part in a clinical trial.

Patients can enter clinical trials before, during, or after starting their cancer treatment.

Follow-up tests may be needed.

There are different types of treatment for childhood acute lymphoblastic leukemia (ALL).

Different types of treatment are available for children withacute lymphoblastic leukemia(ALL).

Some treatments arestandard(the currently used treatment), and some are being tested inclinical

trials.A treatment clinical trial is aresearch studymeant to help improve current treatments or

obtain information on new treatments for patients withcancer.When clinical trials show that a new

treatment is better than the standard treatment, the new treatment may become the standard

treatment.

Because cancer in children is rare, taking part in a clinical trial should be considered. Some clinical

trials are open only to patients who have not started treatment.

Children with ALL should have their treatment planned by a team of doctors with expertise in

treating childhood leukemia.
http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint9http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint9http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint10http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint10http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint10http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint10http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint10http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint11http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint11http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint12http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint12http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint13http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint13http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint14http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint14http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint15http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint15http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint16http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint16http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint17http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint17http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint17http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint17http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint17http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint18http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint18http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint19http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint19http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint20http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint20http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint21http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint21http://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45586&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45586&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45586&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44930&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44930&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44930&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45961&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45961&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45961&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45961&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=651211&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=651211&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=651211&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45333&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45333&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45333&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45333&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=651211&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45961&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45961&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44930&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45586&version=Patient&language=Englishhttp://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint21http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint20http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint19http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint18http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint17http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint17http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint16http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint15http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint14http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint13http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint12http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint11http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint10http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint10http://www.cancer.gov/cancertopics/pdq/treatment/childALL/Patient/page4#Keypoint9


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Treatment will be overseen by apediatric oncologist,a doctor who specializes in treating children

with cancer. The pediatric oncologist works with otherpediatrichealth professionals who are

experts in treating children withleukemiaand who specialize in certain areas ofmedicine.These

may include the followingspecialists:

Hematologist.

Medical oncologist.

Pediatric surgeon.

Radiation oncologist.

Neurologist.

Pathologist.

Radiologist.

Pediatric nurse specialist.

Social worker.

Rehabilitation specialist.

Psychologist.

Regularfollow-upexams are very important. Treatment can causeside effectslong after it has

ended. These are calledlate effects.Radiation therapyto the brain may cause changes in mood,feelings, thinking, learning, or memory. Children younger than 4 years have a higher risk of side

effects from radiation therapy to the brain.

Late effects of treatment for ALL also include the risk ofsecond cancers(new types of cancer),

especiallybrain tumors.

Some late effects may be treated or controlled. It is important to talk with your child's doctors about

the possible late effects caused by some treatments. See thePDQsummary onLate Effects of

Treatment for Childhood Cancer.

The treatment of childhood ALL usually has three phases.

The treatment of childhood ALL is done in phases:

Induction therapy:This is the first phase of treatment. The goal is to kill the leukemiacellsin

thebloodandbone marrow.This puts the leukemia intoremission.This is also called the

remission induction phase.

Consolidation/intensification therapy:This is the second phase oftherapy.It begins once

the leukemia is in remission. The goal of consolidation/intensification therapy is to kill any

remaining leukemia cells that may not be active but could begin to regrow and cause

arelapse.
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ge=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=387264&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=387264&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=387264&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44271&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44271&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44271&version=Patient&language=Englishhttp://www.cancer.gov/cancertopics/pdq/treatment/lateeffects/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/lateeffects/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/lateeffects/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/lateeffects/Patienthttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45736&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45736&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46476&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46476&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46476&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=270735&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=270735&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=270735&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45622&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45622&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45622&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45867&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45867&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45867&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45654&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45654&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=350230&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=350230&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=350230&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44737&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44737&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44737&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45866&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45866&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45866&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45866&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44737&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=350230&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45654&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45867&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45622&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=270735&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46476&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45736&version=Patient&language=Englishhttp://www.cancer.gov/cancertopics/pdq/treatment/lateeffects/Patienthttp://www.cancer.gov/cancertopics/pdq/treatment/lateeffects/Patienthttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44271&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=387264&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46658&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44971&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=390292&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46580&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44671&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44716&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=318825&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=44730&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=318821&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46551&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46244&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46267&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46546&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=318823&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46290&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46370&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=478785&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=482419&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=45343&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=46245&version=Patient&language=Englishhttp://www.cancer.gov/Common/PopUps/popDefinition.aspx?id=693555&version=Patient&language=English


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Maintenance therapy:This is the third phase of treatment. The goal is to kill any remaining

leukemia cells that may regrow and cause a relapse. Often the cancer treatments are given

in lowerdosesthan those used for induction and consolidation/intensification therapy. This

is also called the continuation therapy phase.

Four types of standard treatment are used:

Chemotherapy

Chemotherapyis a cancer treatment that usesdrugsto stop the growth of cancer cells, either by

killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth

orinjectedinto aveinor muscle, the drugs enter the bloodstream and can reach cancer cells

throughout the body (systemic chemotherapy). When chemotherapy is placed directly into

thecerebrospinal fluid(intrathecal), anorgan,or a bodycavitysuch as theabdomen,the drugs

mainly affect cancer cells in those areas (regional chemotherapy).Combination chemotherapyis

treatment using more than one anticancer drug.

The way the chemotherapy is given depends on the child'srisk group.Children with high-risk ALL

receive more anticancer drugs, higher doses of anticancer drugs, and receive treatment for a longer

time than children with standard-risk ALL.

SeeDrugs Approved for Acute Lymphoblastic Leukemiafor more information.

Radiation therapy

Radiation therapyis a cancer treatment that uses high-energyx-raysor other types ofradiationto

kill cancer cells or keep them from growing. There are two types of radiation therapy.Externalradiationtherapy uses a machine outside the body to send radiation toward the cancer.Internal

radiationtherapy uses aradioactivesubstance sealed in needles,seeds,wires, orcathetersthat are

placed directly into or near the cancer. External radiation therapy may be used to treat childhood

ALL that has spread, or may spread, to the brain andspinal cord.

Chemotherapy with stem cell transplant

Stem cell transplantis a method of giving high doses of chemotherapy and sometimesradiation

therapy,and then replacing the blood-forming cells destroyed by the cancer treatment.Stem

cells(immature blood cells) are removed from the blood or bone marrow of adonor.After the

patient receives treatment, the donor's stem cells are given to the patient through aninfusion.

These reinfused stem cells grow into (and restore) the patient's blood cells. The stem cell donor

doesn't have to be related to the patient.

Stem cell transplant is rarely used as initial treatment for children and teenagers with ALL. It is used

more often as part of treatment for ALL that relapses (comes back after treatment).

SeeDrugs Approved for Acute Lymphoblastic Leukemiafor more information.

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