Types of treatment for ALL include systemic chemotherapy, prophylactic CNS chemotherapy (sometimes CNS radiation), and supportive care. For some patients, immunotherapy, targeted therapy, stem cell transplantation and/or radiation therapy might be used. For Philadelphia Chromosome (+) patients, a targeted therapy of a tyrosine kinase inhibitor can be used.
The method of treatment is similar to AML treatment. It begins with induction therapy to induce complete remission (defined as <5% blast cells in the bone marrow, an absolute neutrophil count of >1000/uL, a platelet count of 100,000 and no need for blood transfusion ). The success of initial induction treatment is often indicative of positive overall survival. Typical chemotherapy drugs to induce remission are vincristine, corticosteroids, and an anthracycline.
After induction, some patients may go on to receive an allo-stem cell transplant. Others will go on to receive more chemotherapy in an intensification/consolidation phase.
Following the intensification/consolidation phase, patients may then be put on a maintenance chemotherapy for up to 3 years.
ALL treatment is very complex; it depends on the patient's initial diagnosis, age, general health and initial induction therapy response. There are numerous drugs that are used, as well as radiation, and on the horizon are immunotherapies and targeted therapies.
