Treatment options for ALL include systemic chemotherapy, prophylactic CNS chemotherapy (sometimes CNS radiation), and supportive care. Some patients might also receive immunotherapy, targeted therapy, stem cell transplantation, and/or radiation therapy. For Philadelphia Chromosome (+) patients, targeted therapy with 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 anthracycline.
After induction, some patients may go on to receive an allo-stem cell transplant. Others will receive more chemotherapy in an intensification/consolidation phase.
Following the intensification/consolidation phase, patients may undergo maintenance chemotherapy for up to 3 years.
ALL treatment is complex; it depends on the patient's initial diagnosis, age, general health, and initial induction therapy response. Numerous drugs and radiation are used, and immunotherapies and targeted therapies are on the horizon.
