Materiały źródłowe

• #1 Treating Acute Lymphocytic Leukemia (ALL) | American Cancer Society

  https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/treating.html

  In most cases ALL can progress quickly if not treated, so it’s important to start treatment as soon as possible after the diagnosis is made. […] Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to get state-of-the-art cancer treatment. […] You may hear about alternative or complementary methods to relieve symptoms or treat your cancer that your doctors haven’t mentioned. […] Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known (or not known) about the method, which can help you make an informed decision. […] People with cancer need support and information, no matter what stage of illness they may be in. Knowing all of your options and finding the resources you need will help you make informed decisions about your care.

• #2 Typical Treatment of Acute Lymphocytic Leukemia (ALL) | American Cancer Society

  https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/treating/typical-treatment.html

  The main treatment for acute lymphocytic leukemia (ALL) in adults is typically long-term chemotherapy (chemo). Sometimes other types of drugs, such as targeted drugs or immunotherapy, might be part of the treatment as well. […] Treatment of ALL typically takes place in 3 phases: Induction (remission induction), Consolidation (intensification), Maintenance. […] The goal of induction chemo is to get the leukemia into remission (complete remission). This means that leukemia cells are no longer found in bone marrow samples (on a bone marrow biopsy), the normal marrow cells return, and the blood counts return to normal levels. […] Induction chemo usually lasts for a month or so. […] CNS treatment or prophylaxis: Treatment needs to be given either to keep the leukemia cells from spreading to the CNS (CNS prophylaxis), or to treat the leukemia if it has already spread to the CNS.

• #3 Acute lymphocytic leukemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acute-lymphocytic-leukemia/diagnosis-treatment/drc-20369083

  In general, treatment for acute lymphocytic leukemia falls into separate phases: […] The purpose of the first phase of treatment is to kill most of the leukemia cells in the blood and bone marrow and to restore normal blood cell production. […] Also called post-remission therapy, this phase of treatment is aimed at destroying any remaining leukemia in the body. […] The third phase of treatment prevents leukemia cells from regrowing. The treatments used in this stage are usually given at much lower doses over a long period of time, often years. […] During each phase of therapy, people with acute lymphocytic leukemia may receive additional treatment to kill leukemia cells located in the central nervous system. In this type of treatment, chemotherapy drugs are often injected directly into the fluid that covers the spinal cord.

• #4 Acute lymphocytic leukemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acute-lymphocytic-leukemia/diagnosis-treatment/drc-20369083

  Depending on your situation, the phases of treatment for acute lymphocytic leukemia can span two to three years. […] Treatments may include: […] Chemotherapy, which uses drugs to kill cancer cells, is typically used as an induction therapy for children and adults with acute lymphocytic leukemia. Chemotherapy drugs can also be used in the consolidation and maintenance phases. […] Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die. Your leukemia cells will be tested to see if targeted therapy may be helpful for you. Targeted therapy can be used alone or in combination with chemotherapy for induction therapy, consolidation therapy or maintenance therapy. […] Radiation therapy uses high-powered beams, such as X-rays or protons, to kill cancer cells. If the cancer cells have spread to the central nervous system, your doctor may recommend radiation therapy.

• #5 Treating Acute Lymphocytic Leukemia (ALL) | American Cancer Society

  https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/treating.html

  If you’ve been diagnosed with acute lymphocytic leukemia (ALL), your cancer care team will discuss your treatment options with you. Your options may be affected by the ALL subtype, as well as certain other prognostic factors, as well as your age and overall state of health. […] The main types of treatment used for ALL include: Chemotherapy for Acute Lymphocytic Leukemia (ALL), Targeted Therapy Drugs for Acute Lymphocytic Leukemia (ALL), Immunotherapy for Acute Lymphocytic Leukemia (ALL), Surgery for Acute Lymphocytic Leukemia (ALL), Radiation Therapy for Acute Lymphocytic Leukemia (ALL), Stem Cell Transplant for Acute Lymphocytic Leukemia (ALL). […] Treatment of ALL typically lasts for about 2 years. It is often intense, especially in the first few months of treatment, so it’s important that you are treated in a center that has experience with this disease.

• #6 Treatment for acute lymphoblastic leukaemia (ALL)

  https://www.cancerresearchuk.org/about-cancer/acute-lymphoblastic-leukaemia-all/treatment

  Your treatment depends on several factors. These include what type of ALL you have, the cytogenetics of your leukaemia, and where it is in your body. It also depends on your general health and age. […] The main treatment for acute lymphoblastic leukaemia (ALL) is chemotherapy. But you may also have targeted cancer drugs, immunotherapy, or a stem cell transplant. […] Treatment for ALL usually starts quite quickly after diagnosis. You usually have steroids followed by chemotherapy. Find out about these and other treatments you might have such as a targeted cancer drug or stem cell transplant. […] Treatment for ALL is divided into different phases: induction, consolidation, intensification and maintenance. […] Chemotherapy is the main treatment for acute lymphoblastic leukaemia (ALL).

• #7 Typical Treatment of Acute Lymphocytic Leukemia (ALL) | American Cancer Society

  https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/treating/typical-treatment.html

  The main treatment for acute lymphocytic leukemia (ALL) in adults is typically long-term chemotherapy (chemo). Sometimes other types of drugs, such as targeted drugs or immunotherapy, might be part of the treatment as well. […] Treatment of ALL typically takes place in 3 phases: Induction (remission induction), Consolidation (intensification), Maintenance. […] The goal of induction chemo is to get the leukemia into remission (complete remission). This means that leukemia cells are no longer found in bone marrow samples (on a bone marrow biopsy), the normal marrow cells return, and the blood counts return to normal levels. […] Induction chemo usually lasts for a month or so. […] CNS treatment or prophylaxis: Treatment needs to be given either to keep the leukemia cells from spreading to the CNS (CNS prophylaxis), or to treat the leukemia if it has already spread to the CNS.

• #8 Acute lymphocytic leukemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acute-lymphocytic-leukemia/diagnosis-treatment/drc-20369083

  In general, treatment for acute lymphocytic leukemia falls into separate phases: […] The purpose of the first phase of treatment is to kill most of the leukemia cells in the blood and bone marrow and to restore normal blood cell production. […] Also called post-remission therapy, this phase of treatment is aimed at destroying any remaining leukemia in the body. […] The third phase of treatment prevents leukemia cells from regrowing. The treatments used in this stage are usually given at much lower doses over a long period of time, often years. […] During each phase of therapy, people with acute lymphocytic leukemia may receive additional treatment to kill leukemia cells located in the central nervous system. In this type of treatment, chemotherapy drugs are often injected directly into the fluid that covers the spinal cord.

• #9 Typical Treatment of Acute Lymphocytic Leukemia (ALL) | American Cancer Society

  https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/treating/typical-treatment.html

  The main treatment for acute lymphocytic leukemia (ALL) in adults is typically long-term chemotherapy (chemo). Sometimes other types of drugs, such as targeted drugs or immunotherapy, might be part of the treatment as well. […] Treatment of ALL typically takes place in 3 phases: Induction (remission induction), Consolidation (intensification), Maintenance. […] The goal of induction chemo is to get the leukemia into remission (complete remission). This means that leukemia cells are no longer found in bone marrow samples (on a bone marrow biopsy), the normal marrow cells return, and the blood counts return to normal levels. […] Induction chemo usually lasts for a month or so. […] CNS treatment or prophylaxis: Treatment needs to be given either to keep the leukemia cells from spreading to the CNS (CNS prophylaxis), or to treat the leukemia if it has already spread to the CNS.

• #10 Acute Lymphoblastic Leukemia (ALL) | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/acute-lymphoblastic-leukemia

  Chemotherapy treatment can be divided into these four phases: First phase: Induction chemotherapy, Second phase: Consolidation chemotherapy, Third phase: Maintenance chemotherapy, Fourth phase: Central nervous system (CNS) prophylaxis. The entire treatment process for ALL typically continues for two to three years. […] […] Treatment of ALL is usually urgent and needs to begin within days, and sometimes the same day, as the diagnosis is made. The first phase of treatment, called induction chemotherapy, requires that patients remain in the hospital for approximately four weeks. […] […] The most common induction chemotherapy drugs used for ALL are daunorubicin, vincristine, prednisone, asparaginase and sometimes cyclophosphamide. During this phase, patients receive intensive supportive care, including transfusion of red blood cells and platelets. Antibiotics and anti-fungal medications are used to treat and prevent both bacterial and fungal infections. A medication known as G-CSF (Neupogen) can be used to help quickly reestablish a normal white blood count. […]

• #11 Typical Treatment of Acute Lymphocytic Leukemia (ALL) | American Cancer Society

  https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/treating/typical-treatment.html

  The main treatment for acute lymphocytic leukemia (ALL) in adults is typically long-term chemotherapy (chemo). Sometimes other types of drugs, such as targeted drugs or immunotherapy, might be part of the treatment as well. […] Treatment of ALL typically takes place in 3 phases: Induction (remission induction), Consolidation (intensification), Maintenance. […] The goal of induction chemo is to get the leukemia into remission (complete remission). This means that leukemia cells are no longer found in bone marrow samples (on a bone marrow biopsy), the normal marrow cells return, and the blood counts return to normal levels. […] Induction chemo usually lasts for a month or so. […] CNS treatment or prophylaxis: Treatment needs to be given either to keep the leukemia cells from spreading to the CNS (CNS prophylaxis), or to treat the leukemia if it has already spread to the CNS.

• #12 Acute Lymphoblastic Leukemia (ALL) | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/acute-lymphoblastic-leukemia

  Chemotherapy treatment can be divided into these four phases: First phase: Induction chemotherapy, Second phase: Consolidation chemotherapy, Third phase: Maintenance chemotherapy, Fourth phase: Central nervous system (CNS) prophylaxis. The entire treatment process for ALL typically continues for two to three years. […] […] Treatment of ALL is usually urgent and needs to begin within days, and sometimes the same day, as the diagnosis is made. The first phase of treatment, called induction chemotherapy, requires that patients remain in the hospital for approximately four weeks. […] […] The most common induction chemotherapy drugs used for ALL are daunorubicin, vincristine, prednisone, asparaginase and sometimes cyclophosphamide. During this phase, patients receive intensive supportive care, including transfusion of red blood cells and platelets. Antibiotics and anti-fungal medications are used to treat and prevent both bacterial and fungal infections. A medication known as G-CSF (Neupogen) can be used to help quickly reestablish a normal white blood count. […]

• #13 Acute Lymphocytic Leukemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459149/

  Children who are suspected of having acute lymphocytic leukemia should be referred to a pediatric center that specializes in cancer for evaluation and treatment. […] For children with Acute Lymphocytic Leukemia, induction therapy consists of anthracycline, vincristine, 1-asparaginase, and a corticosteroid. […] Today consolidation therapy is widely used and includes therapy with a variety of chemotherapeutic drugs with good results. […] Maintenance therapy utilizes oral 6-mercaptopurine or methotrexate delivered once weekly or once monthly. Successful treatment of children with acute lymphocytic leukemia involves the administration of a multidrug regimen that is divided into several phases (i.e., induction, consolidation, and maintenance) and includes therapy directed to the central nervous system (CNS).

• #14 Acute Lymphoblastic Leukemia (ALL) Treatment Protocols: Treatment Protocols

  https://emedicine.medscape.com/article/2004705-overview

  Treatment protocols for acute lymphoblastic leukemia (ALL) are provided below, including general treatment recommendations and commonly used treatment recommendations, as well as information on the following: […] The treatment regimen for patients with ALL is determined primarily by the Philadelphia chromosome status of the leukemia and the age of the patient. Patients with Philadelphia chromosome-positive (Ph+) ALL receive a tyrosine kinase inhibitor (TKI) in combination with chemotherapy. […] Treatment recommendations for patients who are diagnosed with ALL include induction, consolidation, and maintenance therapy along with CNS prophylaxis, as follows: […] Patients receive induction therapy with combinations of drugs, including vincristine, prednisone, cyclophosphamide, doxorubicin, and asparaginase, which are given over 4-6 wk.

• #15 Acute Lymphoblastic Leukemia (ALL) | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/acute-lymphoblastic-leukemia

  Chemotherapy treatment can be divided into these four phases: First phase: Induction chemotherapy, Second phase: Consolidation chemotherapy, Third phase: Maintenance chemotherapy, Fourth phase: Central nervous system (CNS) prophylaxis. The entire treatment process for ALL typically continues for two to three years. […] […] Treatment of ALL is usually urgent and needs to begin within days, and sometimes the same day, as the diagnosis is made. The first phase of treatment, called induction chemotherapy, requires that patients remain in the hospital for approximately four weeks. […] […] The most common induction chemotherapy drugs used for ALL are daunorubicin, vincristine, prednisone, asparaginase and sometimes cyclophosphamide. During this phase, patients receive intensive supportive care, including transfusion of red blood cells and platelets. Antibiotics and anti-fungal medications are used to treat and prevent both bacterial and fungal infections. A medication known as G-CSF (Neupogen) can be used to help quickly reestablish a normal white blood count. […]

• #16 Acute Lymphocytic Leukemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459149/

  Children who are suspected of having acute lymphocytic leukemia should be referred to a pediatric center that specializes in cancer for evaluation and treatment. […] For children with Acute Lymphocytic Leukemia, induction therapy consists of anthracycline, vincristine, 1-asparaginase, and a corticosteroid. […] Today consolidation therapy is widely used and includes therapy with a variety of chemotherapeutic drugs with good results. […] Maintenance therapy utilizes oral 6-mercaptopurine or methotrexate delivered once weekly or once monthly. Successful treatment of children with acute lymphocytic leukemia involves the administration of a multidrug regimen that is divided into several phases (i.e., induction, consolidation, and maintenance) and includes therapy directed to the central nervous system (CNS).

• #17 Acute Lymphoblastic Leukemia (ALL) Treatment Protocols: Treatment Protocols

  https://emedicine.medscape.com/article/2004705-overview

  Treatment protocols for acute lymphoblastic leukemia (ALL) are provided below, including general treatment recommendations and commonly used treatment recommendations, as well as information on the following: […] The treatment regimen for patients with ALL is determined primarily by the Philadelphia chromosome status of the leukemia and the age of the patient. Patients with Philadelphia chromosome-positive (Ph+) ALL receive a tyrosine kinase inhibitor (TKI) in combination with chemotherapy. […] Treatment recommendations for patients who are diagnosed with ALL include induction, consolidation, and maintenance therapy along with CNS prophylaxis, as follows: […] Patients receive induction therapy with combinations of drugs, including vincristine, prednisone, cyclophosphamide, doxorubicin, and asparaginase, which are given over 4-6 wk.

• #18 Acute Lymphoblastic Leukemia Treatment (PDQ®) – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65727/

  Treatment options for untreated acute lymphoblastic leukemia (ALL) include: Remission induction therapy, including: Combination chemotherapy. Imatinib mesylate (for patients with Philadelphia chromosome [Ph]positive ALL). Imatinib mesylate combined with combination chemotherapy (for patients with Ph-positive ALL). Supportive care. […] Sixty percent to 80% of adults with ALL usually achieve a complete remission after appropriate induction therapy. Appropriate initial treatment, usually consisting of a regimen that includes the combination of vincristine, prednisone, and an anthracycline, with or without asparaginase, results in a complete response rate of up to 80%. In patients with Ph-positive ALL, the remission rate is generally greater than 90% when standard induction regimens are combined with BCR::ABL1 tyrosine kinase inhibitors.

• #19 Acute Lymphoblastic Leukemia Treatment – NCI

  https://www.cancer.gov/types/leukemia/patient/adult-all-treatment-pdq

  Acute lymphoblastic leukemia (ALL) is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell). […] Acute lymphoblastic leukemia (ALL; also called acute lymphocytic leukemia) is a cancer of the blood and bone marrow. This type of cancer usually gets worse quickly if it is not treated. […] There are different types of treatment for patients with acute lymphoblastic leukemia (ALL). […] The treatment of ALL usually has two phases. […] The following types of treatment are used: chemotherapy, radiation therapy, chemotherapy with stem cell transplant, targeted therapy, immunotherapy. […] Treatment of ALL during the remission induction phase includes: combination chemotherapy, targeted therapy with imatinib, in certain patients, some of whom will also have combination chemotherapy, supportive care including antibiotics and red blood cell and platelet transfusions, central nervous system (CNS) prophylaxis including chemotherapy (intrathecal and/or systemic) with or without radiation therapy to the brain.

• #20 Typical Treatment of Acute Lymphocytic Leukemia (ALL) | American Cancer Society

  https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/treating/typical-treatment.html

  If the leukemia goes into remission, the next phase often consists of another fairly short course of chemo, using many of the same drugs that were used for induction therapy. […] After consolidation, people generally get maintenance chemotherapy with methotrexate and 6-mercaptopurine (6-MP). […] In general, about 80% to 90% of adults will have complete remissions at some point during these treatments. […] If the leukemia is refractory that is, if it doesn’t go away with the first treatment (which happens in about 10% to 20% of people with ALL) then newer or more intensive doses of chemo drugs may be tried, although they are less likely to work. […] If leukemia goes into remission with the initial treatment but then comes back (relapses or recurs), it will most often do so in the bone marrow and blood. […] At some point, it may become clear that further treatment, even in clinical trials, is extremely unlikely to cure the leukemia. At this time, the focus of treatment may shift to controlling the leukemia and its symptoms for as long as possible, rather than trying to cure it.

• #21 Acute Lymphoblastic Leukemia Treatment (PDQ®) – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65727/

  Treatment options for untreated acute lymphoblastic leukemia (ALL) include: Remission induction therapy, including: Combination chemotherapy. Imatinib mesylate (for patients with Philadelphia chromosome [Ph]positive ALL). Imatinib mesylate combined with combination chemotherapy (for patients with Ph-positive ALL). Supportive care. […] Sixty percent to 80% of adults with ALL usually achieve a complete remission after appropriate induction therapy. Appropriate initial treatment, usually consisting of a regimen that includes the combination of vincristine, prednisone, and an anthracycline, with or without asparaginase, results in a complete response rate of up to 80%. In patients with Ph-positive ALL, the remission rate is generally greater than 90% when standard induction regimens are combined with BCR::ABL1 tyrosine kinase inhibitors.

• #22 Acute Lymphoblastic Leukemia (ALL): Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/21564-acute-lymphocytic-leukemia

  Healthcare providers may treat ALL with long-term chemotherapy, targeted therapy, immunotherapy or stem cells (bone marrow) transplantation. Adults and children with ALL may receive different types of cancer drugs and treatments. […] Providers use chemotherapy as initial or front-line treatment for ALL. People with ALL receive chemotherapy in four phases. The treatment goal is to put ALL into complete remission. (Complete remission means treatment eliminates your symptoms, and tests show no sign of cancer.) […] Chemotherapy for ALL takes place over several months and sometimes years, and typically involves high doses of cancer-killing drugs. People receiving chemotherapy for ALL should consider palliative care to help manage treatment side effects. ALL chemotherapy includes: […] Remission induction therapy, which destroys as many leukemia cells as possible, so ALL goes into complete remission. Typically, people remain in the hospital during remission induction therapy. This treatment takes place over four to six weeks. Studies show more than 95% of children and 75% to 80% of adults with ALL will have complete remission after remission induction therapy.

• #23 Acute lymphocytic leukemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acute-lymphocytic-leukemia/diagnosis-treatment/drc-20369083

  In general, treatment for acute lymphocytic leukemia falls into separate phases: […] The purpose of the first phase of treatment is to kill most of the leukemia cells in the blood and bone marrow and to restore normal blood cell production. […] Also called post-remission therapy, this phase of treatment is aimed at destroying any remaining leukemia in the body. […] The third phase of treatment prevents leukemia cells from regrowing. The treatments used in this stage are usually given at much lower doses over a long period of time, often years. […] During each phase of therapy, people with acute lymphocytic leukemia may receive additional treatment to kill leukemia cells located in the central nervous system. In this type of treatment, chemotherapy drugs are often injected directly into the fluid that covers the spinal cord.

• #24 Acute lymphoblastic leukemia treatment – Leukaemia Foundation

  https://www.leukaemia.org.au/blood-cancer/types-of-blood-cancer/leukaemia/acute-lymphoblastic-leukaemia/treatment/

  Treatment for ALL can be divided into three phases: induction therapy, post-remission (consolidation) therapy, maintenance therapy. […] Soon after you are diagnosed your doctor will need to begin an intensive course of treatment to bring about, or induce, a remission. You will need to be admitted to hospital for this first phase of treatment. […] Soon after induction therapy finishes and remission is achieved, more treatment is required to help destroy any leftover disease in your body. This is important because it helps to prevent the disease from reappearing (relapsing), or spreading to the central nervous system (brain and spinal cord) in the future. […] Maintenance therapy is designed to help keep your disease in remission and prevent it from reappearing (relapsing) in the future. Common maintenance protocols involve chemotherapy tablets — some taken daily and others weekly — and possibly blocks of injections of chemotherapy with courses of cortico-steroids. This phase of treatment usually lasts for several months during which time you will be treated as an outpatient; however sometimes you may need to be admitted to hospital.

• #25 Acute lymphoblastic leukemia treatment – Leukaemia Foundation

  https://www.leukaemia.org.au/blood-cancer/types-of-blood-cancer/leukaemia/acute-lymphoblastic-leukaemia/treatment/

  Treatment for ALL can be divided into three phases: induction therapy, post-remission (consolidation) therapy, maintenance therapy. […] Soon after you are diagnosed your doctor will need to begin an intensive course of treatment to bring about, or induce, a remission. You will need to be admitted to hospital for this first phase of treatment. […] Soon after induction therapy finishes and remission is achieved, more treatment is required to help destroy any leftover disease in your body. This is important because it helps to prevent the disease from reappearing (relapsing), or spreading to the central nervous system (brain and spinal cord) in the future. […] Maintenance therapy is designed to help keep your disease in remission and prevent it from reappearing (relapsing) in the future. Common maintenance protocols involve chemotherapy tablets — some taken daily and others weekly — and possibly blocks of injections of chemotherapy with courses of cortico-steroids. This phase of treatment usually lasts for several months during which time you will be treated as an outpatient; however sometimes you may need to be admitted to hospital.

• #26 Typical Treatment of Acute Lymphocytic Leukemia (ALL) | American Cancer Society

  https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/treating/typical-treatment.html

  If the leukemia goes into remission, the next phase often consists of another fairly short course of chemo, using many of the same drugs that were used for induction therapy. […] After consolidation, people generally get maintenance chemotherapy with methotrexate and 6-mercaptopurine (6-MP). […] In general, about 80% to 90% of adults will have complete remissions at some point during these treatments. […] If the leukemia is refractory that is, if it doesn’t go away with the first treatment (which happens in about 10% to 20% of people with ALL) then newer or more intensive doses of chemo drugs may be tried, although they are less likely to work. […] If leukemia goes into remission with the initial treatment but then comes back (relapses or recurs), it will most often do so in the bone marrow and blood. […] At some point, it may become clear that further treatment, even in clinical trials, is extremely unlikely to cure the leukemia. At this time, the focus of treatment may shift to controlling the leukemia and its symptoms for as long as possible, rather than trying to cure it.

• #27 Acute Lymphoblastic Leukemia (ALL) | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/acute-lymphoblastic-leukemia

  Once blood counts have returned to normal, another bone marrow biopsy is performed to determine if the patient has entered complete remission. A complete remission is achieved when the blood and bone marrow show no evidence of persistent leukemia and blood counts have returned to normal. […] […] Chemotherapy drugs used during consolidation include the same ones used during induction, as well as Ara-C, etoposide, methotrexate and 6-mercaptopurine. The consolidation phase typically includes multiple cycles of intensive chemotherapy given over a six- to nine-month period. Frequent hospitalizations and intensive supportive care are still needed, including red blood cell and platelet transfusions. […] […] Once patients have completed intensive chemotherapy, they need to take oral chemotherapy pills for an additional 18 to 24 months. These pills typically methotrexate and 6-mercaptopurine are usually well-tolerated with only minimal side effects. Patients need to have blood tests once a month while taking chemotherapy pills. Most patients with ALL can return to work during maintenance therapy. […]

• #28 Acute Lymphoblastic Leukemia (ALL) | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/acute-lymphoblastic-leukemia

  Once blood counts have returned to normal, another bone marrow biopsy is performed to determine if the patient has entered complete remission. A complete remission is achieved when the blood and bone marrow show no evidence of persistent leukemia and blood counts have returned to normal. […] […] Chemotherapy drugs used during consolidation include the same ones used during induction, as well as Ara-C, etoposide, methotrexate and 6-mercaptopurine. The consolidation phase typically includes multiple cycles of intensive chemotherapy given over a six- to nine-month period. Frequent hospitalizations and intensive supportive care are still needed, including red blood cell and platelet transfusions. […] […] Once patients have completed intensive chemotherapy, they need to take oral chemotherapy pills for an additional 18 to 24 months. These pills typically methotrexate and 6-mercaptopurine are usually well-tolerated with only minimal side effects. Patients need to have blood tests once a month while taking chemotherapy pills. Most patients with ALL can return to work during maintenance therapy. […]

• #29 Acute Lymphoblastic Leukemia Treatment – NCI

  https://www.cancer.gov/types/leukemia/patient/adult-all-treatment-pdq

  Treatment of ALL during the post-remission phase includes: chemotherapy, targeted therapy with dasatinib, imatinib, or nilotinib, chemotherapy with stem cell transplant, central nervous system (CNS prophylaxis) including chemotherapy (intrathecal and/or systemic) with or without radiation therapy to the brain. […] Treatment of recurrent ALL may include: combination chemotherapy followed by stem cell transplant, immunotherapy (blinatumomab or inotuzumab ozogamicin) followed by stem cell transplant, low-dose radiation therapy as palliative care to relieve symptoms and improve quality of life, targeted therapy with dasatinib or revumenib for certain patients, CAR T-cell therapy (brexucabtagene autoleucel or tisagenlecleucel) for certain patients.

• #30 Acute Lymphoblastic Leukemia (ALL) | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/acute-lymphoblastic-leukemia

  Once blood counts have returned to normal, another bone marrow biopsy is performed to determine if the patient has entered complete remission. A complete remission is achieved when the blood and bone marrow show no evidence of persistent leukemia and blood counts have returned to normal. […] […] Chemotherapy drugs used during consolidation include the same ones used during induction, as well as Ara-C, etoposide, methotrexate and 6-mercaptopurine. The consolidation phase typically includes multiple cycles of intensive chemotherapy given over a six- to nine-month period. Frequent hospitalizations and intensive supportive care are still needed, including red blood cell and platelet transfusions. […] […] Once patients have completed intensive chemotherapy, they need to take oral chemotherapy pills for an additional 18 to 24 months. These pills typically methotrexate and 6-mercaptopurine are usually well-tolerated with only minimal side effects. Patients need to have blood tests once a month while taking chemotherapy pills. Most patients with ALL can return to work during maintenance therapy. […]

• #31 Acute Lymphoblastic Leukemia Treatment – NCI

  https://www.cancer.gov/types/leukemia/patient/adult-all-treatment-pdq

  Treatment of ALL during the post-remission phase includes: chemotherapy, targeted therapy with dasatinib, imatinib, or nilotinib, chemotherapy with stem cell transplant, central nervous system (CNS prophylaxis) including chemotherapy (intrathecal and/or systemic) with or without radiation therapy to the brain. […] Treatment of recurrent ALL may include: combination chemotherapy followed by stem cell transplant, immunotherapy (blinatumomab or inotuzumab ozogamicin) followed by stem cell transplant, low-dose radiation therapy as palliative care to relieve symptoms and improve quality of life, targeted therapy with dasatinib or revumenib for certain patients, CAR T-cell therapy (brexucabtagene autoleucel or tisagenlecleucel) for certain patients.

• #32 Acute Lymphoblastic Leukemia (ALL) | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/acute-lymphoblastic-leukemia

  Once blood counts have returned to normal, another bone marrow biopsy is performed to determine if the patient has entered complete remission. A complete remission is achieved when the blood and bone marrow show no evidence of persistent leukemia and blood counts have returned to normal. […] […] Chemotherapy drugs used during consolidation include the same ones used during induction, as well as Ara-C, etoposide, methotrexate and 6-mercaptopurine. The consolidation phase typically includes multiple cycles of intensive chemotherapy given over a six- to nine-month period. Frequent hospitalizations and intensive supportive care are still needed, including red blood cell and platelet transfusions. […] […] Once patients have completed intensive chemotherapy, they need to take oral chemotherapy pills for an additional 18 to 24 months. These pills typically methotrexate and 6-mercaptopurine are usually well-tolerated with only minimal side effects. Patients need to have blood tests once a month while taking chemotherapy pills. Most patients with ALL can return to work during maintenance therapy. […]

• #33 Acute Lymphoblastic Leukemia (ALL): Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/21564-acute-lymphocytic-leukemia

  Central nervous system-directed therapy to kill any leukemia cells in your central nervous system and keep ALL from spreading to your spinal fluid. (System-directed means you have chemotherapy that affects your entire body or system.) […] Consolidation therapy begins once ALL is in remission. This treatment works to destroy as many remaining cancerous cells as possible. Consolidation therapy involves being in the hospital for several months while you receive high-dose chemotherapy administered weekly. […] Continuation or maintenance therapy is a long-term treatment that may last two to three years. You dont have to be in the hospital to receive maintenance therapy. […] Targeted therapy focuses on specific genetic changes. About 25% of adults and some children with ALL have chromosomal mutations. Healthcare providers currently use tyrosine kinase (TKI) therapy to treat ALL in children and adults with a specific mutation called Philadelphia chromosome or t(9;22). TKI therapy blocks an enzyme essential for ALL growth. TKI therapy kills ALL cells so your body gets back to normal blood cell production.

• #34 Acute lymphocytic leukemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acute-lymphocytic-leukemia/diagnosis-treatment/drc-20369083

  In general, treatment for acute lymphocytic leukemia falls into separate phases: […] The purpose of the first phase of treatment is to kill most of the leukemia cells in the blood and bone marrow and to restore normal blood cell production. […] Also called post-remission therapy, this phase of treatment is aimed at destroying any remaining leukemia in the body. […] The third phase of treatment prevents leukemia cells from regrowing. The treatments used in this stage are usually given at much lower doses over a long period of time, often years. […] During each phase of therapy, people with acute lymphocytic leukemia may receive additional treatment to kill leukemia cells located in the central nervous system. In this type of treatment, chemotherapy drugs are often injected directly into the fluid that covers the spinal cord.

• #35 Acute lymphocytic leukemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acute-lymphocytic-leukemia/diagnosis-treatment/drc-20369083

  Depending on your situation, the phases of treatment for acute lymphocytic leukemia can span two to three years. […] Treatments may include: […] Chemotherapy, which uses drugs to kill cancer cells, is typically used as an induction therapy for children and adults with acute lymphocytic leukemia. Chemotherapy drugs can also be used in the consolidation and maintenance phases. […] Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die. Your leukemia cells will be tested to see if targeted therapy may be helpful for you. Targeted therapy can be used alone or in combination with chemotherapy for induction therapy, consolidation therapy or maintenance therapy. […] Radiation therapy uses high-powered beams, such as X-rays or protons, to kill cancer cells. If the cancer cells have spread to the central nervous system, your doctor may recommend radiation therapy.

• #36 Treating Acute Lymphocytic Leukemia (ALL) | American Cancer Society

  https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/treating.html

  If you’ve been diagnosed with acute lymphocytic leukemia (ALL), your cancer care team will discuss your treatment options with you. Your options may be affected by the ALL subtype, as well as certain other prognostic factors, as well as your age and overall state of health. […] The main types of treatment used for ALL include: Chemotherapy for Acute Lymphocytic Leukemia (ALL), Targeted Therapy Drugs for Acute Lymphocytic Leukemia (ALL), Immunotherapy for Acute Lymphocytic Leukemia (ALL), Surgery for Acute Lymphocytic Leukemia (ALL), Radiation Therapy for Acute Lymphocytic Leukemia (ALL), Stem Cell Transplant for Acute Lymphocytic Leukemia (ALL). […] Treatment of ALL typically lasts for about 2 years. It is often intense, especially in the first few months of treatment, so it’s important that you are treated in a center that has experience with this disease.

• #37 Acute Lymphoblastic Leukemia (ALL) | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/acute-lymphoblastic-leukemia

  Once blood counts have returned to normal, another bone marrow biopsy is performed to determine if the patient has entered complete remission. A complete remission is achieved when the blood and bone marrow show no evidence of persistent leukemia and blood counts have returned to normal. […] […] Chemotherapy drugs used during consolidation include the same ones used during induction, as well as Ara-C, etoposide, methotrexate and 6-mercaptopurine. The consolidation phase typically includes multiple cycles of intensive chemotherapy given over a six- to nine-month period. Frequent hospitalizations and intensive supportive care are still needed, including red blood cell and platelet transfusions. […] […] Once patients have completed intensive chemotherapy, they need to take oral chemotherapy pills for an additional 18 to 24 months. These pills typically methotrexate and 6-mercaptopurine are usually well-tolerated with only minimal side effects. Patients need to have blood tests once a month while taking chemotherapy pills. Most patients with ALL can return to work during maintenance therapy. […]

• #38 Acute Lymphoblastic Leukaemia (Symptoms and Treatment)

  https://patient.info/doctor/acute-lymphoblastic-leukaemia-pro

  Maintenance therapy usually consists of daily 6-mercaptopurine and weekly methotrexate. In some treatment regimens, repeated cycles of vincristine, dexamethasone or other drugs in monthly or longer intervals are given. A treatment duration of 2.5-3 years is usually recommended. […] The incorporation of CNS prophylaxis, consisting of cranial radiation and intrathecal chemotherapy, has led to effective control of CNS disease and reduced the incidence of CNS leukaemia from over 65% to less than 10%. […] SCT allows intensification of chemotherapies and radiotherapies as it replaces destroyed stem cells. […] Relapse has a very poor prognosis in patients with acute lymphoblastic leukaemia. Most patients are referred for trial 'salvage’ therapies. […] New treatment strategies in development include the use of monoclonal antibodies against antigens found on leukaemic cells, cellular immunotherapy and molecular therapeutics.

• #39 Acute Lymphoblastic Leukemia (ALL) | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/acute-lymphoblastic-leukemia

  Once blood counts have returned to normal, another bone marrow biopsy is performed to determine if the patient has entered complete remission. A complete remission is achieved when the blood and bone marrow show no evidence of persistent leukemia and blood counts have returned to normal. […] […] Chemotherapy drugs used during consolidation include the same ones used during induction, as well as Ara-C, etoposide, methotrexate and 6-mercaptopurine. The consolidation phase typically includes multiple cycles of intensive chemotherapy given over a six- to nine-month period. Frequent hospitalizations and intensive supportive care are still needed, including red blood cell and platelet transfusions. […] […] Once patients have completed intensive chemotherapy, they need to take oral chemotherapy pills for an additional 18 to 24 months. These pills typically methotrexate and 6-mercaptopurine are usually well-tolerated with only minimal side effects. Patients need to have blood tests once a month while taking chemotherapy pills. Most patients with ALL can return to work during maintenance therapy. […]

• #40 Acute Lymphoblastic Leukaemia (Symptoms and Treatment)

  https://patient.info/doctor/acute-lymphoblastic-leukaemia-pro

  Maintenance therapy usually consists of daily 6-mercaptopurine and weekly methotrexate. In some treatment regimens, repeated cycles of vincristine, dexamethasone or other drugs in monthly or longer intervals are given. A treatment duration of 2.5-3 years is usually recommended. […] The incorporation of CNS prophylaxis, consisting of cranial radiation and intrathecal chemotherapy, has led to effective control of CNS disease and reduced the incidence of CNS leukaemia from over 65% to less than 10%. […] SCT allows intensification of chemotherapies and radiotherapies as it replaces destroyed stem cells. […] Relapse has a very poor prognosis in patients with acute lymphoblastic leukaemia. Most patients are referred for trial 'salvage’ therapies. […] New treatment strategies in development include the use of monoclonal antibodies against antigens found on leukaemic cells, cellular immunotherapy and molecular therapeutics.

• #41 Acute Lymphoblastic Leukemia (ALL) | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/acute-lymphoblastic-leukemia

  Once blood counts have returned to normal, another bone marrow biopsy is performed to determine if the patient has entered complete remission. A complete remission is achieved when the blood and bone marrow show no evidence of persistent leukemia and blood counts have returned to normal. […] […] Chemotherapy drugs used during consolidation include the same ones used during induction, as well as Ara-C, etoposide, methotrexate and 6-mercaptopurine. The consolidation phase typically includes multiple cycles of intensive chemotherapy given over a six- to nine-month period. Frequent hospitalizations and intensive supportive care are still needed, including red blood cell and platelet transfusions. […] […] Once patients have completed intensive chemotherapy, they need to take oral chemotherapy pills for an additional 18 to 24 months. These pills typically methotrexate and 6-mercaptopurine are usually well-tolerated with only minimal side effects. Patients need to have blood tests once a month while taking chemotherapy pills. Most patients with ALL can return to work during maintenance therapy. […]

• #42 Treatments – Acute lymphoblastic leukemia – Cancer Institute | Northwell Health

  https://cancer.northwell.edu/cancer-care/acute-lymphocytic-leukemia/treatments

  Treating acute lymphoblastic leukemia […] Northwell Health combines advanced technologies and innovative therapies to aggressively treat acute lymphoblastic leukemia (ALL). […] We use state-of-the-art technology and the latest clinically proven therapies to treat newly diagnosed, relapsed and refractory ALL. Every one of our patients gets a unique, personalized treatment plan developed by a multidisciplinary team of specialists who will remain at your service for the duration of your care. Our broader clinical care and research teams meet regularly to discuss each patient’s diagnosis and therapy, so youll benefit from the expertise of some of New Yorks top doctors in the field. From diagnosis through treatment, youre in the most capable hands. […] Most treatment plans for ALL have three steps. These are induction, consolidation and maintenance. […] Induction therapy kills leukemia cells in the blood and bone marrow to induce remission. This inpatient treatment includes chemotherapy and corticosteroids, and usually lasts four weeks. […] Also called post-remission therapy, the aim is to kill any remaining leukemia cells (even though they may not show up in tests) and prevent a recurrence of leukemia. Treatment usually includes more chemotherapy and may also include a stem cell transplant, or preventive treatment of the brain or spinal cord with radiation or chemotherapy. Consolidation can take several months but doesn’t require a stay in the hospital. […] This prevents any remaining leukemia cells from growing and can be done using lower doses of orally administered chemotherapy with a once-a-month intravenous (IV) treatment. Maintenance may last up to three years, but during this time most people can go back to being as active as they were before treatment. […] When someone shows no signs of leukemia for five years, theyre usually considered cured. If the leukemia doesn’t go into remission or comes back within the first few years, more chemotherapy, a stem cell transplant, or joining a clinical trial for new treatments are all options that can be explored.

• #43 Typical Treatment of Acute Lymphocytic Leukemia (ALL) | American Cancer Society

  https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/treating/typical-treatment.html

  The main treatment for acute lymphocytic leukemia (ALL) in adults is typically long-term chemotherapy (chemo). Sometimes other types of drugs, such as targeted drugs or immunotherapy, might be part of the treatment as well. […] Treatment of ALL typically takes place in 3 phases: Induction (remission induction), Consolidation (intensification), Maintenance. […] The goal of induction chemo is to get the leukemia into remission (complete remission). This means that leukemia cells are no longer found in bone marrow samples (on a bone marrow biopsy), the normal marrow cells return, and the blood counts return to normal levels. […] Induction chemo usually lasts for a month or so. […] CNS treatment or prophylaxis: Treatment needs to be given either to keep the leukemia cells from spreading to the CNS (CNS prophylaxis), or to treat the leukemia if it has already spread to the CNS.

• #44 Acute Lymphoblastic Leukemia (ALL) | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/acute-lymphoblastic-leukemia

  ALL often recurs in the cerebrospinal fluid the fluid that bathes the spinal column and brain. To prevent this, chemotherapy is injected directly into the cerebrospinal fluid. This is done by inserting a needle between the vertebrae of the lower back called a spinal tap or lumbar puncture and infusing chemotherapy directly into the clear cerebrospinal fluid. This procedure is called intrathecal chemotherapy. […] […] ALL patients are prone to viral infections and to a pneumonia called pneumocystis during their treatment. Antibiotics, such as acyclovir and Septra or Bactrim, are given during ALL therapy to help prevent these infections. […] […] Stem cell transplantation, also called blood or marrow transplantation (BMT), is only performed in patients who have abnormal cytogenetics (chromosome testing) or other features of high-risk ALL. Cytogenetics is the most important factor in deciding whether a person should have a bone marrow transplant for ALL. Patients with the Philadelphia chromosome or with the translocation involving chromosomes 4 and 11, should go on to BMT. […]

• #45 Acute Lymphoblastic Leukemia | Acute Lymphocytic Leukemia | MedlinePlus

  https://medlineplus.gov/acutelymphocyticleukemia.html

  What are the treatments for acute lymphocytic leukemia (ALL)? Treatments for ALL include: […] Chemotherapy […] Radiation therapy […] Chemotherapy with stem cell transplant […] Targeted therapy, which uses drugs or other substances that attack specific cancer cells with less harm to normal cells. […] Treatment is usually done in two phases: […] The goal of the first phase is to kill the leukemia cells in the blood and bone marrow. This treatment puts the leukemia into remission. Remission means that the signs and symptoms of cancer are reduced or have disappeared. […] The second phase is known as post-remission therapy. Its goal is to prevent a relapse (return) of the cancer. It involves killing any remaining leukemia cells that may not be active but could begin to regrow. […] Treatment during both phases also usually includes central nervous system (CNS) prophylaxis therapy. This therapy helps prevent the spread of leukemia cells to the brain and spinal cord. It may be high dose chemotherapy or chemotherapy injected into the spinal cord. It also sometimes includes radiation therapy.

• #46 Acute Lymphoblastic Leukemia Treatment – NCI

  https://www.cancer.gov/types/leukemia/patient/adult-all-treatment-pdq

  Acute lymphoblastic leukemia (ALL) is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell). […] Acute lymphoblastic leukemia (ALL; also called acute lymphocytic leukemia) is a cancer of the blood and bone marrow. This type of cancer usually gets worse quickly if it is not treated. […] There are different types of treatment for patients with acute lymphoblastic leukemia (ALL). […] The treatment of ALL usually has two phases. […] The following types of treatment are used: chemotherapy, radiation therapy, chemotherapy with stem cell transplant, targeted therapy, immunotherapy. […] Treatment of ALL during the remission induction phase includes: combination chemotherapy, targeted therapy with imatinib, in certain patients, some of whom will also have combination chemotherapy, supportive care including antibiotics and red blood cell and platelet transfusions, central nervous system (CNS) prophylaxis including chemotherapy (intrathecal and/or systemic) with or without radiation therapy to the brain.

• #47 Acute Lymphoblastic Leukemia (ALL) | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/acute-lymphoblastic-leukemia

  ALL often recurs in the cerebrospinal fluid the fluid that bathes the spinal column and brain. To prevent this, chemotherapy is injected directly into the cerebrospinal fluid. This is done by inserting a needle between the vertebrae of the lower back called a spinal tap or lumbar puncture and infusing chemotherapy directly into the clear cerebrospinal fluid. This procedure is called intrathecal chemotherapy. […] […] ALL patients are prone to viral infections and to a pneumonia called pneumocystis during their treatment. Antibiotics, such as acyclovir and Septra or Bactrim, are given during ALL therapy to help prevent these infections. […] […] Stem cell transplantation, also called blood or marrow transplantation (BMT), is only performed in patients who have abnormal cytogenetics (chromosome testing) or other features of high-risk ALL. Cytogenetics is the most important factor in deciding whether a person should have a bone marrow transplant for ALL. Patients with the Philadelphia chromosome or with the translocation involving chromosomes 4 and 11, should go on to BMT. […]

• #48 Acute Lymphocytic Leukemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459149/

  Most treatment protocols take two to three years to complete. […] CNS prophylaxis is done via an intrathecal approach. Patients often require 8 to 16 intrathecal treatments. […] If the patient has Ph-chromosome positive ALL, the current treatment includes the use of tyrosine kinase inhibitors like imatinib, nilotinib, dasatinib, or ponatinib. Several trials have shown a good response to these agents. […] Stem cell transplantation can sometimes be used as a treatment in which a patient’s normal source of blood cells (bone marrow) is replaced by healthy young blood cells (stem cells) from a healthy well-matched donor. However, with improvements in chemotherapy, the role of transplantation is declining in ALL. […] Recently CAR-T cell therapy has been investigated in ALL with excellent results. Several studies show high rates of remission. Unfortunately, CART is also associated with serious toxicity that includes cerebral edema and cytokine release syndrome, which can be fatal.

• #49 Acute Lymphoblastic Leukemia Treatment (PDQ®) – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65727/

  This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of acute lymphoblastic leukemia. It is intended as a resource to inform and assist clinicians in the care of their patients. It does not provide formal guidelines or recommendations for making health care decisions. […] Successful treatment of acute lymphoblastic leukemia (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). 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.

• #50 Acute Lymphoblastic Leukemia (ALL) Treatment | St. Jude Care & Treatment

  https://www.stjude.org/care-treatment/treatment/childhood-cancer/leukemia-lymphoma/acute-lymphoblastic-leukemia-all.html

  Your child’s oncologist will discuss treatment options with you. […] St. Jude has led the way in how the world treats childhood leukemia since the hospital opened in 1962. […] St. Jude patients with ALL have a 94% survival rate. […] St. Jude investigators showed that radiation can be safely omitted from the treatment of most patients with ALL. […] St. Jude researchers found that there are more than 30 subtypes of ALL. They are based on changes in genes and chromosomes in the leukemia cells. This finding has transformed treatment for ALL. Treatment plans are now based on a child’s subtype and how it responds to specific treatments. […] At St. Jude, children with ALL can take part in clinical trials if they choose. These studies use the most advanced treatments available. Our goal is to improve each child’s chance of cure and to reduce the side effects of treatment.

• #51 Acute Lymphoblastic Leukemia (ALL) | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/acute-lymphoblastic-leukemia

  ALL often recurs in the cerebrospinal fluid the fluid that bathes the spinal column and brain. To prevent this, chemotherapy is injected directly into the cerebrospinal fluid. This is done by inserting a needle between the vertebrae of the lower back called a spinal tap or lumbar puncture and infusing chemotherapy directly into the clear cerebrospinal fluid. This procedure is called intrathecal chemotherapy. […] […] ALL patients are prone to viral infections and to a pneumonia called pneumocystis during their treatment. Antibiotics, such as acyclovir and Septra or Bactrim, are given during ALL therapy to help prevent these infections. […] […] Stem cell transplantation, also called blood or marrow transplantation (BMT), is only performed in patients who have abnormal cytogenetics (chromosome testing) or other features of high-risk ALL. Cytogenetics is the most important factor in deciding whether a person should have a bone marrow transplant for ALL. Patients with the Philadelphia chromosome or with the translocation involving chromosomes 4 and 11, should go on to BMT. […]

• #52 Acute Lymphoblastic Leukemia Treatment (PDQ®) – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65727/

  This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of acute lymphoblastic leukemia. It is intended as a resource to inform and assist clinicians in the care of their patients. It does not provide formal guidelines or recommendations for making health care decisions. […] Successful treatment of acute lymphoblastic leukemia (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). 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.

• #53 Acute Lymphocytic Leukemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459149/

  Most treatment protocols take two to three years to complete. […] CNS prophylaxis is done via an intrathecal approach. Patients often require 8 to 16 intrathecal treatments. […] If the patient has Ph-chromosome positive ALL, the current treatment includes the use of tyrosine kinase inhibitors like imatinib, nilotinib, dasatinib, or ponatinib. Several trials have shown a good response to these agents. […] Stem cell transplantation can sometimes be used as a treatment in which a patient’s normal source of blood cells (bone marrow) is replaced by healthy young blood cells (stem cells) from a healthy well-matched donor. However, with improvements in chemotherapy, the role of transplantation is declining in ALL. […] Recently CAR-T cell therapy has been investigated in ALL with excellent results. Several studies show high rates of remission. Unfortunately, CART is also associated with serious toxicity that includes cerebral edema and cytokine release syndrome, which can be fatal.

• #54 Treating Acute Lymphocytic Leukemia (ALL) | American Cancer Society

  https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/treating.html

  If you’ve been diagnosed with acute lymphocytic leukemia (ALL), your cancer care team will discuss your treatment options with you. Your options may be affected by the ALL subtype, as well as certain other prognostic factors, as well as your age and overall state of health. […] The main types of treatment used for ALL include: Chemotherapy for Acute Lymphocytic Leukemia (ALL), Targeted Therapy Drugs for Acute Lymphocytic Leukemia (ALL), Immunotherapy for Acute Lymphocytic Leukemia (ALL), Surgery for Acute Lymphocytic Leukemia (ALL), Radiation Therapy for Acute Lymphocytic Leukemia (ALL), Stem Cell Transplant for Acute Lymphocytic Leukemia (ALL). […] Treatment of ALL typically lasts for about 2 years. It is often intense, especially in the first few months of treatment, so it’s important that you are treated in a center that has experience with this disease.

• #55 Treatment for acute lymphoblastic leukaemia (ALL)

  https://www.cancerresearchuk.org/about-cancer/acute-lymphoblastic-leukaemia-all/treatment

  Your treatment depends on several factors. These include what type of ALL you have, the cytogenetics of your leukaemia, and where it is in your body. It also depends on your general health and age. […] The main treatment for acute lymphoblastic leukaemia (ALL) is chemotherapy. But you may also have targeted cancer drugs, immunotherapy, or a stem cell transplant. […] Treatment for ALL usually starts quite quickly after diagnosis. You usually have steroids followed by chemotherapy. Find out about these and other treatments you might have such as a targeted cancer drug or stem cell transplant. […] Treatment for ALL is divided into different phases: induction, consolidation, intensification and maintenance. […] Chemotherapy is the main treatment for acute lymphoblastic leukaemia (ALL).

• #56 Acute lymphoblastic leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Acute_lymphoblastic_leukemia

  Chemotherapy is the initial treatment of choice, and most people with ALL receive a combination of medications. […] In general, cytotoxic chemotherapy for ALL combines multiple antileukemic drugs tailored to each person. […] Adult chemotherapy regimens mimic those of childhood ALL; however, are linked with a higher risk of disease relapse with chemotherapy alone. […] Recent updates on the treatment of adult acute lymphoblastic leukemia (ALL) include advancements in immunotherapy, particularly the use of monoclonal antibodies like blinatumomab and inotuzumab ozogamicin, which target specific cancer cells and are used alongside stem cell transplantation. […] Radiation therapy (or radiotherapy) is used on painful bony areas, in high disease burdens, or as part of the preparations for a bone marrow transplant (total body irradiation).

• #57 Treating Acute Lymphocytic Leukemia (ALL) | American Cancer Society

  https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/treating.html

  If you’ve been diagnosed with acute lymphocytic leukemia (ALL), your cancer care team will discuss your treatment options with you. Your options may be affected by the ALL subtype, as well as certain other prognostic factors, as well as your age and overall state of health. […] The main types of treatment used for ALL include: Chemotherapy for Acute Lymphocytic Leukemia (ALL), Targeted Therapy Drugs for Acute Lymphocytic Leukemia (ALL), Immunotherapy for Acute Lymphocytic Leukemia (ALL), Surgery for Acute Lymphocytic Leukemia (ALL), Radiation Therapy for Acute Lymphocytic Leukemia (ALL), Stem Cell Transplant for Acute Lymphocytic Leukemia (ALL). […] Treatment of ALL typically lasts for about 2 years. It is often intense, especially in the first few months of treatment, so it’s important that you are treated in a center that has experience with this disease.

• #58 Treatment for acute lymphoblastic leukaemia (ALL leukemia) | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/leukaemia/acute-lymphoblastic-leukaemia-all-treatment

  There are different treatments for acute lymphoblastic leukaemia. Treatment usually starts as soon as possible after diagnosis. […] The aim of treatment for acute lymphoblastic leukaemia (also called ALL or ALL leukemia) is to get rid of the leukaemia cells as quickly as possible, so your bone marrow can work normally again. This is called remission. […] Treatment options include: […] Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy the cancer cells. This is the main treatment for ALL. You will have several different chemotherapy drugs. Most of the drugs will be given into a vein (intravenously). You will take others by mouth as tablets. […] At times during treatment you will have chemotherapy given into the fluid around your spine and brain (cerebrospinal fluid). This is called intrathecal chemotherapy. It may be given to treat or prevent leukaemia in this area of the body.

• #59 Treating Acute Lymphocytic Leukemia (ALL) | American Cancer Society

  https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/treating.html

  If you’ve been diagnosed with acute lymphocytic leukemia (ALL), your cancer care team will discuss your treatment options with you. Your options may be affected by the ALL subtype, as well as certain other prognostic factors, as well as your age and overall state of health. […] The main types of treatment used for ALL include: Chemotherapy for Acute Lymphocytic Leukemia (ALL), Targeted Therapy Drugs for Acute Lymphocytic Leukemia (ALL), Immunotherapy for Acute Lymphocytic Leukemia (ALL), Surgery for Acute Lymphocytic Leukemia (ALL), Radiation Therapy for Acute Lymphocytic Leukemia (ALL), Stem Cell Transplant for Acute Lymphocytic Leukemia (ALL). […] Treatment of ALL typically lasts for about 2 years. It is often intense, especially in the first few months of treatment, so it’s important that you are treated in a center that has experience with this disease.

• #60 Treatment for acute lymphoblastic leukaemia (ALL leukemia) | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/leukaemia/acute-lymphoblastic-leukaemia-all-treatment

  There are different treatments for acute lymphoblastic leukaemia. Treatment usually starts as soon as possible after diagnosis. […] The aim of treatment for acute lymphoblastic leukaemia (also called ALL or ALL leukemia) is to get rid of the leukaemia cells as quickly as possible, so your bone marrow can work normally again. This is called remission. […] Treatment options include: […] Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy the cancer cells. This is the main treatment for ALL. You will have several different chemotherapy drugs. Most of the drugs will be given into a vein (intravenously). You will take others by mouth as tablets. […] At times during treatment you will have chemotherapy given into the fluid around your spine and brain (cerebrospinal fluid). This is called intrathecal chemotherapy. It may be given to treat or prevent leukaemia in this area of the body.

• #61 Acute Lymphoblastic Leukemia (ALL) Treatment Protocols: Treatment Protocols

  https://emedicine.medscape.com/article/2004705-overview

  Patients then receive consolidation (intensification) with multiagent therapy, including cytarabine and methotrexate; there is no role for radiation or surgical treatment in the induction phase. […] Maintenance therapy includes 6-mercaptopurine, methotrexate, steroids, and vincristine; intrathecal methotrexate is administered throughout. […] Newer studies with intensive multiagent chemotherapy (eg, the CALGB [Cancer and Leukemia Group B]- 8811 and hyper-CVAD [hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone] regimens and the ALL-2 regimen) plus the addition of TKIs for Ph+ ALL and rituximab for CD20-positive ALL have resulted in 3-y survivals of 50% or more in adults. […] Chemotherapy (eg, hyper-CVAD) plus TKI; consider allogeneic stem cell transplantation if an appropriate donor is available and the patient has a good performance status and no or limited comorbidities; if transplantation is not feasible, continue multiagent chemotherapy and a TKI.

• #62 Medication for Acute Lymphoblastic Leukemia | NYU Langone Health

  https://nyulangone.org/conditions/acute-lymphoblastic-leukemia/treatments/medication-for-acute-lymphoblastic-leukemia

  Medication for Acute Lymphoblastic Leukemia […] NYU Langone oncologists and hematologists at Perlmutter Cancer Center, who specialize in managing blood cancer, often use chemotherapy, a group of drugs that destroy cancer cells throughout the body, to treat acute lymphoblastic leukemia. […] If the cancer has certain genetic features, doctors may also prescribe targeted drugs, which are designed to eliminate cancer cells while sparing healthy tissue. […] Chemotherapy for acute lymphoblastic leukemia almost always includes a combination of medications. Conventional treatment involves giving chemotherapy in three phasesinduction, consolidation, and maintenance. This treatment regimen often involves high doses of drugs. […] This regimen may be too strong for you because of other health conditions. In that case, doctors can modify the treatment. Some people find certain combinations of chemotherapy more tolerable than others. […] For example, doctors may recommend using a combination of drugs called hyper-CVAD in older adults. Hyper refers to giving more than one treatment with the same medication during a single day, and CVAD stands for the different drugs used: cyclophosphamide, vincristine sulfate, Adriamycin, and dexamethasone. Also, NYU Langone doctors may use pediatric-inspired treatmenta combination of drugs successfully used in childrenin younger adults. […] For these approaches, doctors usually combine several chemotherapy drugs during the first few days of a treatment cyclea three- or four-week periodwith additional chemotherapy drugs given during the in-between days. Treatment is given in an outpatient setting and can last for six months or longer. […] Often, doctors perform screening lumbar punctures during treatment because some of the chemotherapy drugs are injected in the lower spine. This approach, called intrathecal chemotherapy, is used to prevent acute lymphoblastic leukemia from spreading to the central nervous systemthe brain and spinal cord.

• #63 How I treat newly diagnosed acute lymphoblastic leukemia | Published in Clinical Hematology International

  https://chi.scholasticahq.com/article/117026-how-i-treat-newly-diagnosed-acute-lymphoblastic-leukemia

  For patients with Ph- ALL, PIR is a standard of care. A meta-analysis of 25 studies comparing the results of pediatric protocols with those originally designed for adults showed an approximately 20% overall survival advantage at 5 years in favor of the pediatric ones in AYA. Direct implementation of pediatric protocols may be considered for patients up to 40 years old. The treatment intensity should be tapered for individuals between 40 and 55 years old. For those aged 55 years or more, the therapy should be personalized and adjusted to the performance status and comorbidities. […] The treatment of adults with ALL traditionally consists of polychemotherapy. It includes several phases: a pre-treatment phase, mainly using glucocorticoids, followed by an induction phase, aimed at achieving complete remission (CR), and a consolidation phase to perpetuate the state of CR. Follow-up is either maintenance therapy or an allogeneic hematopoietic cell transplantation (allo-HCT), which is recommended for patients with a high estimated risk of disease recurrence.

• #64 Acute lymphocytic leukemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acute-lymphocytic-leukemia/diagnosis-treatment/drc-20369083

  Depending on your situation, the phases of treatment for acute lymphocytic leukemia can span two to three years. […] Treatments may include: […] Chemotherapy, which uses drugs to kill cancer cells, is typically used as an induction therapy for children and adults with acute lymphocytic leukemia. Chemotherapy drugs can also be used in the consolidation and maintenance phases. […] Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die. Your leukemia cells will be tested to see if targeted therapy may be helpful for you. Targeted therapy can be used alone or in combination with chemotherapy for induction therapy, consolidation therapy or maintenance therapy. […] Radiation therapy uses high-powered beams, such as X-rays or protons, to kill cancer cells. If the cancer cells have spread to the central nervous system, your doctor may recommend radiation therapy.

• #65 Acute Lymphoblastic Leukemia (ALL): Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/21564-acute-lymphocytic-leukemia

  Central nervous system-directed therapy to kill any leukemia cells in your central nervous system and keep ALL from spreading to your spinal fluid. (System-directed means you have chemotherapy that affects your entire body or system.) […] Consolidation therapy begins once ALL is in remission. This treatment works to destroy as many remaining cancerous cells as possible. Consolidation therapy involves being in the hospital for several months while you receive high-dose chemotherapy administered weekly. […] Continuation or maintenance therapy is a long-term treatment that may last two to three years. You dont have to be in the hospital to receive maintenance therapy. […] Targeted therapy focuses on specific genetic changes. About 25% of adults and some children with ALL have chromosomal mutations. Healthcare providers currently use tyrosine kinase (TKI) therapy to treat ALL in children and adults with a specific mutation called Philadelphia chromosome or t(9;22). TKI therapy blocks an enzyme essential for ALL growth. TKI therapy kills ALL cells so your body gets back to normal blood cell production.

• #66 Acute Lymphoblastic Leukemia Treatment – NCI

  https://www.cancer.gov/types/leukemia/patient/adult-all-treatment-pdq

  Treatment of ALL during the post-remission phase includes: chemotherapy, targeted therapy with dasatinib, imatinib, or nilotinib, chemotherapy with stem cell transplant, central nervous system (CNS prophylaxis) including chemotherapy (intrathecal and/or systemic) with or without radiation therapy to the brain. […] Treatment of recurrent ALL may include: combination chemotherapy followed by stem cell transplant, immunotherapy (blinatumomab or inotuzumab ozogamicin) followed by stem cell transplant, low-dose radiation therapy as palliative care to relieve symptoms and improve quality of life, targeted therapy with dasatinib or revumenib for certain patients, CAR T-cell therapy (brexucabtagene autoleucel or tisagenlecleucel) for certain patients.

• #67 Acute Lymphocytic Leukemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459149/

  Most treatment protocols take two to three years to complete. […] CNS prophylaxis is done via an intrathecal approach. Patients often require 8 to 16 intrathecal treatments. […] If the patient has Ph-chromosome positive ALL, the current treatment includes the use of tyrosine kinase inhibitors like imatinib, nilotinib, dasatinib, or ponatinib. Several trials have shown a good response to these agents. […] Stem cell transplantation can sometimes be used as a treatment in which a patient’s normal source of blood cells (bone marrow) is replaced by healthy young blood cells (stem cells) from a healthy well-matched donor. However, with improvements in chemotherapy, the role of transplantation is declining in ALL. […] Recently CAR-T cell therapy has been investigated in ALL with excellent results. Several studies show high rates of remission. Unfortunately, CART is also associated with serious toxicity that includes cerebral edema and cytokine release syndrome, which can be fatal.

• #68 Acute Lymphoblastic Leukemia Treatment – NCI

  https://www.cancer.gov/types/leukemia/patient/adult-all-treatment-pdq

  Treatment of ALL during the post-remission phase includes: chemotherapy, targeted therapy with dasatinib, imatinib, or nilotinib, chemotherapy with stem cell transplant, central nervous system (CNS prophylaxis) including chemotherapy (intrathecal and/or systemic) with or without radiation therapy to the brain. […] Treatment of recurrent ALL may include: combination chemotherapy followed by stem cell transplant, immunotherapy (blinatumomab or inotuzumab ozogamicin) followed by stem cell transplant, low-dose radiation therapy as palliative care to relieve symptoms and improve quality of life, targeted therapy with dasatinib or revumenib for certain patients, CAR T-cell therapy (brexucabtagene autoleucel or tisagenlecleucel) for certain patients.

• #69 Acute Lymphocytic Leukemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459149/

  Most treatment protocols take two to three years to complete. […] CNS prophylaxis is done via an intrathecal approach. Patients often require 8 to 16 intrathecal treatments. […] If the patient has Ph-chromosome positive ALL, the current treatment includes the use of tyrosine kinase inhibitors like imatinib, nilotinib, dasatinib, or ponatinib. Several trials have shown a good response to these agents. […] Stem cell transplantation can sometimes be used as a treatment in which a patient’s normal source of blood cells (bone marrow) is replaced by healthy young blood cells (stem cells) from a healthy well-matched donor. However, with improvements in chemotherapy, the role of transplantation is declining in ALL. […] Recently CAR-T cell therapy has been investigated in ALL with excellent results. Several studies show high rates of remission. Unfortunately, CART is also associated with serious toxicity that includes cerebral edema and cytokine release syndrome, which can be fatal.

• #70 Acute Lymphoblastic Leukemia Treatment (PDQ®) – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65727/

  Treatment options for untreated acute lymphoblastic leukemia (ALL) include: Remission induction therapy, including: Combination chemotherapy. Imatinib mesylate (for patients with Philadelphia chromosome [Ph]positive ALL). Imatinib mesylate combined with combination chemotherapy (for patients with Ph-positive ALL). Supportive care. […] Sixty percent to 80% of adults with ALL usually achieve a complete remission after appropriate induction therapy. Appropriate initial treatment, usually consisting of a regimen that includes the combination of vincristine, prednisone, and an anthracycline, with or without asparaginase, results in a complete response rate of up to 80%. In patients with Ph-positive ALL, the remission rate is generally greater than 90% when standard induction regimens are combined with BCR::ABL1 tyrosine kinase inhibitors.

• #71 Acute Lymphoblastic Leukemia Treatment – NCI

  https://www.cancer.gov/types/leukemia/patient/adult-all-treatment-pdq

  Acute lymphoblastic leukemia (ALL) is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell). […] Acute lymphoblastic leukemia (ALL; also called acute lymphocytic leukemia) is a cancer of the blood and bone marrow. This type of cancer usually gets worse quickly if it is not treated. […] There are different types of treatment for patients with acute lymphoblastic leukemia (ALL). […] The treatment of ALL usually has two phases. […] The following types of treatment are used: chemotherapy, radiation therapy, chemotherapy with stem cell transplant, targeted therapy, immunotherapy. […] Treatment of ALL during the remission induction phase includes: combination chemotherapy, targeted therapy with imatinib, in certain patients, some of whom will also have combination chemotherapy, supportive care including antibiotics and red blood cell and platelet transfusions, central nervous system (CNS) prophylaxis including chemotherapy (intrathecal and/or systemic) with or without radiation therapy to the brain.

• #72 Treatment for acute lymphoblastic leukaemia (ALL leukemia) | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/leukaemia/acute-lymphoblastic-leukaemia-all-treatment

  You almost always have steroids during treatment for ALL. You usually start having steroids a few days before you start chemotherapy. Steroids can: destroy leukaemia cells, make chemotherapy more effective, reduce allergic reactions caused by some chemotherapy drugs, prevent side effects such as feeling sick (nausea). […] If tests show you have a type of ALL called Philadelphia positive ALL (Ph+ ALL), your treatment will include a type of targeted therapy drug called a tyrosine kinase inhibitor (TKI). Imatinib is the most commonly used TKI drug for ALL. […] Immunotherapy drugs use the body’s own immune system to recognise and destroy leukaemia cells. A drug called rituximab is sometimes used to treat B-cell ALL if tests show the leukaemia cells have a protein called CD20 on their surface.

• #73 Acute lymphoblastic leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Acute_lymphoblastic_leukemia

  Chemotherapy is the initial treatment of choice, and most people with ALL receive a combination of medications. […] In general, cytotoxic chemotherapy for ALL combines multiple antileukemic drugs tailored to each person. […] Adult chemotherapy regimens mimic those of childhood ALL; however, are linked with a higher risk of disease relapse with chemotherapy alone. […] Recent updates on the treatment of adult acute lymphoblastic leukemia (ALL) include advancements in immunotherapy, particularly the use of monoclonal antibodies like blinatumomab and inotuzumab ozogamicin, which target specific cancer cells and are used alongside stem cell transplantation. […] Radiation therapy (or radiotherapy) is used on painful bony areas, in high disease burdens, or as part of the preparations for a bone marrow transplant (total body irradiation).

• #74 Treatment for acute lymphoblastic leukaemia (ALL leukemia) | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/leukaemia/acute-lymphoblastic-leukaemia-all-treatment

  You almost always have steroids during treatment for ALL. You usually start having steroids a few days before you start chemotherapy. Steroids can: destroy leukaemia cells, make chemotherapy more effective, reduce allergic reactions caused by some chemotherapy drugs, prevent side effects such as feeling sick (nausea). […] If tests show you have a type of ALL called Philadelphia positive ALL (Ph+ ALL), your treatment will include a type of targeted therapy drug called a tyrosine kinase inhibitor (TKI). Imatinib is the most commonly used TKI drug for ALL. […] Immunotherapy drugs use the body’s own immune system to recognise and destroy leukaemia cells. A drug called rituximab is sometimes used to treat B-cell ALL if tests show the leukaemia cells have a protein called CD20 on their surface.

• #75 How I treat newly diagnosed acute lymphoblastic leukemia | Published in Clinical Hematology International

  https://chi.scholasticahq.com/article/117026-how-i-treat-newly-diagnosed-acute-lymphoblastic-leukemia

  In recent years, immunotherapy appears increasingly important in addition to chemotherapy for adults with Ph- ALL. As demonstrated by the French study group, introducing an anti-CD20 antibody, rituximab, to all treatment phases for patients with CD20-positive ALL contributes to improved event-free survival (EFS) and reduced incidence of relapse. […] Blinatumomab, a bispecific anti-CD19/anti-CD3 T-cell enhancer, has been approved for treating patients in CR with MRD levels10-3 in the bone marrow. As shown by the results of the phase II study, it may allow for the eradication of MRD in 78% of patients in the first or subsequent CR. It may be considered a bridge to allow HCT. However, the need for transplantation after blinatumomab remains controversial. […] For patients with Ph+ ALL the use of TKI is a priority. Imatinib in combination with reduced-intensity chemotherapy, followed by allo-HCT is currently recommended. Front-line dasatinib or ponatinib, in sequence or in combination with blinatumomab, is a promising strategy, which may allow to avoid systemic chemotherapy. The future role of allo-HCT in this context appears uncertain.

• #76 Acute Lymphoblastic Leukemia Treatment – NCI

  https://www.cancer.gov/types/leukemia/patient/adult-all-treatment-pdq

  Treatment of ALL during the post-remission phase includes: chemotherapy, targeted therapy with dasatinib, imatinib, or nilotinib, chemotherapy with stem cell transplant, central nervous system (CNS prophylaxis) including chemotherapy (intrathecal and/or systemic) with or without radiation therapy to the brain. […] Treatment of recurrent ALL may include: combination chemotherapy followed by stem cell transplant, immunotherapy (blinatumomab or inotuzumab ozogamicin) followed by stem cell transplant, low-dose radiation therapy as palliative care to relieve symptoms and improve quality of life, targeted therapy with dasatinib or revumenib for certain patients, CAR T-cell therapy (brexucabtagene autoleucel or tisagenlecleucel) for certain patients.

• #77 Acute Lymphoblastic Leukemia Treatment (PDQ®) – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65727/

  Patients with ALL who experience a relapse after chemotherapy and maintenance therapy are unlikely to be cured by further chemotherapy alone. These patients should be considered for reinduction chemotherapy followed by allogeneic BMT. […] Blinatumomab is a bispecific antibody targeting CD19 and CD3. The U.S. Food and Drug Administration (FDA) has approved blinatumomab for use in patients with relapsed or refractory B-cell ALL. […] Inotuzumab ozogamicin is an antibody-drug conjugate targeting CD22, which contains a conjugated toxin, calicheamicin. The FDA has approved inotuzumab ozogamicin for use in patients with relapsed or refractory B-cell ALL with CD22 expression. […] Patients with Ph-positive ALL are often taking imatinib at the time of relapse and thus have imatinib-resistant disease. Dasatinib is a novel tyrosine kinase inhibitor with efficacy against several different imatinib-resistant BCR::ABL1 fusion gene variants. Dasatinib has been approved for use in patients with Ph-positive ALL who are resistant to, or intolerant of, imatinib. […] Revumenib is an oral menin inhibitor that is approved by the FDA for the treatment of relapsed or refractory acute leukemia with a KMT2A translocation in adult and pediatric patients aged 1 year and older.

• #78 Acute Lymphoblastic Leukemia Treatment (PDQ®) – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65727/

  Patients with ALL who experience a relapse after chemotherapy and maintenance therapy are unlikely to be cured by further chemotherapy alone. These patients should be considered for reinduction chemotherapy followed by allogeneic BMT. […] Blinatumomab is a bispecific antibody targeting CD19 and CD3. The U.S. Food and Drug Administration (FDA) has approved blinatumomab for use in patients with relapsed or refractory B-cell ALL. […] Inotuzumab ozogamicin is an antibody-drug conjugate targeting CD22, which contains a conjugated toxin, calicheamicin. The FDA has approved inotuzumab ozogamicin for use in patients with relapsed or refractory B-cell ALL with CD22 expression. […] Patients with Ph-positive ALL are often taking imatinib at the time of relapse and thus have imatinib-resistant disease. Dasatinib is a novel tyrosine kinase inhibitor with efficacy against several different imatinib-resistant BCR::ABL1 fusion gene variants. Dasatinib has been approved for use in patients with Ph-positive ALL who are resistant to, or intolerant of, imatinib. […] Revumenib is an oral menin inhibitor that is approved by the FDA for the treatment of relapsed or refractory acute leukemia with a KMT2A translocation in adult and pediatric patients aged 1 year and older.

• #79

  https://link.springer.com/article/10.1007/s11864-024-01213-4

  Inotuzumab is an anti-CD22 monoclonal antibody that is bound to the cytotoxic anti-tumor antibiotic calicheamicin. […] FDA approval for inotuzumab is based on results of the randomized, phase III INO-VATE trial comparing inotuzumab to the standard of care in r/r B-ALL. […] The CR/CRi rate in the intention-to-treat analysis was 80.7% compared to 29.4% with chemotherapy. […] The only FDA approved therapy for relapsed T-ALL remains Nelarabine. […] Recently, inclusion of the BCL2 inhibitor Venetoclax has shown promise in combination regimens for r/r T-ALL, although these studies have enrolled small numbers of patients.

• #80 Treatment for acute lymphoblastic leukaemia (ALL leukemia) | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/leukaemia/acute-lymphoblastic-leukaemia-all-treatment

  You almost always have steroids during treatment for ALL. You usually start having steroids a few days before you start chemotherapy. Steroids can: destroy leukaemia cells, make chemotherapy more effective, reduce allergic reactions caused by some chemotherapy drugs, prevent side effects such as feeling sick (nausea). […] If tests show you have a type of ALL called Philadelphia positive ALL (Ph+ ALL), your treatment will include a type of targeted therapy drug called a tyrosine kinase inhibitor (TKI). Imatinib is the most commonly used TKI drug for ALL. […] Immunotherapy drugs use the body’s own immune system to recognise and destroy leukaemia cells. A drug called rituximab is sometimes used to treat B-cell ALL if tests show the leukaemia cells have a protein called CD20 on their surface.

• #81 Acute Lymphoblastic Leukemia Treatment (PDQ®) – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65727/

  Patients with ALL who experience a relapse after chemotherapy and maintenance therapy are unlikely to be cured by further chemotherapy alone. These patients should be considered for reinduction chemotherapy followed by allogeneic BMT. […] Blinatumomab is a bispecific antibody targeting CD19 and CD3. The U.S. Food and Drug Administration (FDA) has approved blinatumomab for use in patients with relapsed or refractory B-cell ALL. […] Inotuzumab ozogamicin is an antibody-drug conjugate targeting CD22, which contains a conjugated toxin, calicheamicin. The FDA has approved inotuzumab ozogamicin for use in patients with relapsed or refractory B-cell ALL with CD22 expression. […] Patients with Ph-positive ALL are often taking imatinib at the time of relapse and thus have imatinib-resistant disease. Dasatinib is a novel tyrosine kinase inhibitor with efficacy against several different imatinib-resistant BCR::ABL1 fusion gene variants. Dasatinib has been approved for use in patients with Ph-positive ALL who are resistant to, or intolerant of, imatinib. […] Revumenib is an oral menin inhibitor that is approved by the FDA for the treatment of relapsed or refractory acute leukemia with a KMT2A translocation in adult and pediatric patients aged 1 year and older.

• #82 Acute lymphocytic leukemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acute-lymphocytic-leukemia/diagnosis-treatment/drc-20369083

  A bone marrow transplant, also known as a stem cell transplant, may be used as consolidation therapy or for treating relapse if it occurs. This procedure allows someone with leukemia to reestablish healthy bone marrow by replacing leukemic bone marrow with leukemia-free marrow from a healthy person. […] A specialized treatment called chimeric antigen receptor (CAR)-T cell therapy takes your body’s germ-fighting T cells, engineers them to fight cancer and infuses them back into your body. […] Clinical trials are experiments to test new cancer treatments and new ways of using existing treatments. While clinical trials give you or your child a chance to try the latest cancer treatment, the benefits and risks of the treatment may be uncertain. Discuss the benefits and risks of clinical trials with your doctor.

• #83 Acute Lymphoblastic Leukemia (ALL): Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/21564-acute-lymphocytic-leukemia

  Immunotherapy helps your bodys own immune system attack cancer cells. Immunotherapy for ALL may include CAR-T cell therapy or monoclonal antibody therapy. […] Healthcare providers may recommend radiation therapy to treat recurrent ALL or ALL that doesnt respond to chemotherapy. Recently, providers have used radiation therapy to treat ALL thats spread (metastasized) to peoples brains or spinal fluid. […] When other treatments havent eliminated ALL, a healthcare provider may recommend allogeneic stem cell (bone marrow) transplantation to treat adults with acute lymphoblastic leukemia.

• #84 Use of CAR T-cell for acute lymphoblastic leukemia (ALL) treatment: a review study | Cancer Gene Therapy

  https://www.nature.com/articles/s41417-021-00418-1

  There are currently five FDA-approved CAR T-cell therapies, including Lisocabtagene Maraleucel (Breyanzi), Axicabtagene Ciloleucel (Yescarta), Brexucabtagene Autoleucel (Tecartus), Idecabtagene Vicleucel (Abecma), and Tisagenlecleucel (Kymriah). […] Major advantages of CAR T-cell therapies are the low number of infusions needed, short treatment period, and rapid recovery than traditional treatments. […] Although the rate of the primary response to CAR T-cell therapy in B-cell malignancies for relapsed or refractory disease is remarkably effective and is related to a CRi/CR (7490%) in some clinical trials still many patients fail to respond or relapse after the initial treatment. […] One clear way to overcome the antigen loss challenge after CAR T-cell therapy is using more than one target.

• #85 Acute Lymphoblastic Leukemia (ALL) Treatment Protocols: Treatment Protocols

  https://emedicine.medscape.com/article/2004705-overview

  For this reason, clinical trials are now ongoing to determine whether the prognosis of ALL in adults can be improved by giving pediatric-style regimens in the younger-adult population. […] Stem cell transplantation represents the most intensive postremission therapy and potentially increases a patient’s chance for cure. […] The prognosis for patients who experience relapse after front-line therapy is poor, with very few patients surviving long term. The best outcome is obtained if patients achieve a second remission and then proceed to allogeneic stem cell transplantation. […] Most of the chemotherapy regimens used for front-line therapy of ALL can be used in the salvage setting; however, response rates are low and remission durations are short. […] Blinatumomab, a bispecific T-cell engager (BiTE) antibody, is approved for Ph- relapsed or refractory B-cell ALL; treatment cycles consist of 4 wk continuous IV infusion with at least a 2-wk treatment-free interval between cycles. […] Three chimeric antigen receptor (CAR) T-cell therapies have been approved for treatment of relapsed or refractory B-cell precursor ALL.

• #86 Use of CAR T-cell for acute lymphoblastic leukemia (ALL) treatment: a review study | Cancer Gene Therapy

  https://www.nature.com/articles/s41417-021-00418-1

  There are currently five FDA-approved CAR T-cell therapies, including Lisocabtagene Maraleucel (Breyanzi), Axicabtagene Ciloleucel (Yescarta), Brexucabtagene Autoleucel (Tecartus), Idecabtagene Vicleucel (Abecma), and Tisagenlecleucel (Kymriah). […] Major advantages of CAR T-cell therapies are the low number of infusions needed, short treatment period, and rapid recovery than traditional treatments. […] Although the rate of the primary response to CAR T-cell therapy in B-cell malignancies for relapsed or refractory disease is remarkably effective and is related to a CRi/CR (7490%) in some clinical trials still many patients fail to respond or relapse after the initial treatment. […] One clear way to overcome the antigen loss challenge after CAR T-cell therapy is using more than one target.

• #87 Acute Lymphoblastic Leukemia (ALL) Treatment Protocols: Treatment Protocols

  https://emedicine.medscape.com/article/2004705-overview

  For this reason, clinical trials are now ongoing to determine whether the prognosis of ALL in adults can be improved by giving pediatric-style regimens in the younger-adult population. […] Stem cell transplantation represents the most intensive postremission therapy and potentially increases a patient’s chance for cure. […] The prognosis for patients who experience relapse after front-line therapy is poor, with very few patients surviving long term. The best outcome is obtained if patients achieve a second remission and then proceed to allogeneic stem cell transplantation. […] Most of the chemotherapy regimens used for front-line therapy of ALL can be used in the salvage setting; however, response rates are low and remission durations are short. […] Blinatumomab, a bispecific T-cell engager (BiTE) antibody, is approved for Ph- relapsed or refractory B-cell ALL; treatment cycles consist of 4 wk continuous IV infusion with at least a 2-wk treatment-free interval between cycles. […] Three chimeric antigen receptor (CAR) T-cell therapies have been approved for treatment of relapsed or refractory B-cell precursor ALL.

• #88 Acute Lymphocytic Leukemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459149/

  Most treatment protocols take two to three years to complete. […] CNS prophylaxis is done via an intrathecal approach. Patients often require 8 to 16 intrathecal treatments. […] If the patient has Ph-chromosome positive ALL, the current treatment includes the use of tyrosine kinase inhibitors like imatinib, nilotinib, dasatinib, or ponatinib. Several trials have shown a good response to these agents. […] Stem cell transplantation can sometimes be used as a treatment in which a patient’s normal source of blood cells (bone marrow) is replaced by healthy young blood cells (stem cells) from a healthy well-matched donor. However, with improvements in chemotherapy, the role of transplantation is declining in ALL. […] Recently CAR-T cell therapy has been investigated in ALL with excellent results. Several studies show high rates of remission. Unfortunately, CART is also associated with serious toxicity that includes cerebral edema and cytokine release syndrome, which can be fatal.

• #89 Use of CAR T-cell for acute lymphoblastic leukemia (ALL) treatment: a review study | Cancer Gene Therapy

  https://www.nature.com/articles/s41417-021-00418-1

  A phase I/II clinical trial performed at the UPenn and childrens hospital of Philadelphia (CHOP) employed a lentiviral engineered autologous T-cell construct expressing a second-generation CAR composed of anti-CD19 scFv, CD3 as a signaling domain, and 41BB as the costimulatory domain. […] Several target antigens have been investigated for CAR T-cell therapy in both preclinical and clinical trials. […] The combination of multi-antigen targeting may increase the effectiveness of this therapeutic approach. […] Clinical trials of CAR T-cells in the treatment of multiple hematologic malignancies, including ALL, chronic lymphocytic leukemia (CLL), and non-Hodgkin lymphoma (NHL) has significantly improved the perspective of children with recurrent/resistant disease. […] The two major toxicities associated with CAR-T therapy are cytokine release syndrome (CRS) and the Immune effector cell-associated neurotoxicity syndrome (ICANS) in ALL patients compared to other B-cell malignancies, particularly in adults.

• #90 Acute lymphocytic leukemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acute-lymphocytic-leukemia/diagnosis-treatment/drc-20369083

  A bone marrow transplant, also known as a stem cell transplant, may be used as consolidation therapy or for treating relapse if it occurs. This procedure allows someone with leukemia to reestablish healthy bone marrow by replacing leukemic bone marrow with leukemia-free marrow from a healthy person. […] A specialized treatment called chimeric antigen receptor (CAR)-T cell therapy takes your body’s germ-fighting T cells, engineers them to fight cancer and infuses them back into your body. […] Clinical trials are experiments to test new cancer treatments and new ways of using existing treatments. While clinical trials give you or your child a chance to try the latest cancer treatment, the benefits and risks of the treatment may be uncertain. Discuss the benefits and risks of clinical trials with your doctor.

• #91 Treatment for acute lymphoblastic leukaemia (ALL)

  https://www.cancerresearchuk.org/about-cancer/acute-lymphoblastic-leukaemia-all/treatment

  You may have immunotherapy or a targeted cancer drug to help treat some types of ALL. Targeted cancer drugs work by targeting the differences in cancer cells that help them to grow and survive. Immunotherapy, such as CAR T-cell therapy uses the immune system to attack the cancer. […] You might have a stem cell transplant as part of your treatment for ALL. In ALL, you have the stem cells from someone else (a donor). This is called an allogeneic transplant. […] Leukaemia that does not go away with treatment is called refractory leukaemia. If it comes back after treatment it is called relapsed disease. Find out about possible treatment options and ways to help you cope with this situation. […] Treatment for acute lymphoblastic leukaemia (ALL) might cause short and long term side effects. Short term side effects happen during treatment or very soon after you finish. Long term side effects can develop weeks, months or years after treatment has ended. […] You have follow up appointments and tests after treatment for ALL to check how you are and monitor any side effects or symptoms.

• #92 Patient education: Acute lymphoblastic leukemia (ALL) treatment in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/acute-lymphoblastic-leukemia-all-treatment-in-adults-beyond-the-basics

  Consolidation/intensification therapy – This phase happens after remission has been achieved, and involves more chemotherapy, other medications, and/or stem cell transplantation to prevent a relapse. […] Remission maintenance (or continuation) therapy – This treatment is intended to prevent relapse and involves alternating chemotherapy sessions with oral medications (pills), usually over two to three years. […] Stem cell transplantation, also called bone marrow transplantation or hematopoietic stem cell transplantation, is a treatment in which the patient’s normal source of blood cells (the bone marrow) is replaced by healthy bone marrow cells (called stem cells) from a healthy genetically well-matched donor. […] Allogeneic transplantation uses stem cells from a donor other than the patient, ideally a sibling with a similar genetic makeup (called a matched related donor).

• #93 How I treat newly diagnosed acute lymphoblastic leukemia | Published in Clinical Hematology International

  https://chi.scholasticahq.com/article/117026-how-i-treat-newly-diagnosed-acute-lymphoblastic-leukemia

  Allo-HCT is currently recommended for high-risk patients with Ph- ALL and all patients with Ph+ ALL treated with upfront imatinib. The choice of potential donors is wide, including MSD, MUD, mismatched unrelated donors (MMUD) and haploidentical relatives. The intensity of conditioning may be adjusted to the recipients biological status, which means that almost all patients with indications for allo-HCT may be offered this procedure. […] Chimeric antigen receptor (CAR) T-cells are genetically engineered T lymphocytes able to recognize and destroy cancer cells. Two products representing autologous CAR T-cells, tisagenlecleucel and brexucaptagene autoleucel have been approved for the treatment of relapsed/refractory B-ALL. Such therapy could potentially be offered to patients in CR1 with detectable MRD. In this clinical situation, CAR T-cells would be a final treatment, allowing to avoid allo-HCT. Clinical studies exploring this concept are ongoing.

• #94 Phases of treatment for acute lymphoblastic leukaemia (ALL)

  https://www.cancerresearchuk.org/about-cancer/acute-lymphoblastic-leukaemia-all/treatment/phases

  After you’ve finished the induction phase and your blood count has recovered, you have another bone marrow test. This is to check how well the treatment has worked. […] Doctors know that even if your leukaemia is in remission after the first cycle of treatment, you have to continue treatment or it will come back (recur). […] Depending on this risk, you might have one or more of the following: more chemotherapy, a targeted cancer drug called a tyrosine kinase inhibitor (TKI), a targeted cancer drug called a monoclonal antibody, a stem cell transplant using cells from a donor, CAR T-cell therapy. […] In ALL treatment, you have a transplant using another person’s stem cells. […] The last phase of ALL treatment is maintenance therapy. It helps to keep the leukaemia away (in remission). […] You usually have low dose chemotherapy every day, which you take as a tablet. […] Your doctor follows you up closely after you finish maintenance treatment. […] Your doctor may offer you treatment as part of a clinical trial.

• #95 How I treat newly diagnosed acute lymphoblastic leukemia | Published in Clinical Hematology International

  https://chi.scholasticahq.com/article/117026-how-i-treat-newly-diagnosed-acute-lymphoblastic-leukemia

  Allo-HCT is currently recommended for high-risk patients with Ph- ALL and all patients with Ph+ ALL treated with upfront imatinib. The choice of potential donors is wide, including MSD, MUD, mismatched unrelated donors (MMUD) and haploidentical relatives. The intensity of conditioning may be adjusted to the recipients biological status, which means that almost all patients with indications for allo-HCT may be offered this procedure. […] Chimeric antigen receptor (CAR) T-cells are genetically engineered T lymphocytes able to recognize and destroy cancer cells. Two products representing autologous CAR T-cells, tisagenlecleucel and brexucaptagene autoleucel have been approved for the treatment of relapsed/refractory B-ALL. Such therapy could potentially be offered to patients in CR1 with detectable MRD. In this clinical situation, CAR T-cells would be a final treatment, allowing to avoid allo-HCT. Clinical studies exploring this concept are ongoing.

• #96 Phases of treatment for acute lymphoblastic leukaemia (ALL)

  https://www.cancerresearchuk.org/about-cancer/acute-lymphoblastic-leukaemia-all/treatment/phases

  After you’ve finished the induction phase and your blood count has recovered, you have another bone marrow test. This is to check how well the treatment has worked. […] Doctors know that even if your leukaemia is in remission after the first cycle of treatment, you have to continue treatment or it will come back (recur). […] Depending on this risk, you might have one or more of the following: more chemotherapy, a targeted cancer drug called a tyrosine kinase inhibitor (TKI), a targeted cancer drug called a monoclonal antibody, a stem cell transplant using cells from a donor, CAR T-cell therapy. […] In ALL treatment, you have a transplant using another person’s stem cells. […] The last phase of ALL treatment is maintenance therapy. It helps to keep the leukaemia away (in remission). […] You usually have low dose chemotherapy every day, which you take as a tablet. […] Your doctor follows you up closely after you finish maintenance treatment. […] Your doctor may offer you treatment as part of a clinical trial.

• #97 Patient education: Acute lymphoblastic leukemia (ALL) treatment in adults (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/acute-lymphoblastic-leukemia-all-treatment-in-adults-beyond-the-basics

  Consolidation/intensification therapy – This phase happens after remission has been achieved, and involves more chemotherapy, other medications, and/or stem cell transplantation to prevent a relapse. […] Remission maintenance (or continuation) therapy – This treatment is intended to prevent relapse and involves alternating chemotherapy sessions with oral medications (pills), usually over two to three years. […] Stem cell transplantation, also called bone marrow transplantation or hematopoietic stem cell transplantation, is a treatment in which the patient’s normal source of blood cells (the bone marrow) is replaced by healthy bone marrow cells (called stem cells) from a healthy genetically well-matched donor. […] Allogeneic transplantation uses stem cells from a donor other than the patient, ideally a sibling with a similar genetic makeup (called a matched related donor).

• #98 How I treat newly diagnosed acute lymphoblastic leukemia | Published in Clinical Hematology International

  https://chi.scholasticahq.com/article/117026-how-i-treat-newly-diagnosed-acute-lymphoblastic-leukemia

  Allo-HCT is currently recommended for high-risk patients with Ph- ALL and all patients with Ph+ ALL treated with upfront imatinib. The choice of potential donors is wide, including MSD, MUD, mismatched unrelated donors (MMUD) and haploidentical relatives. The intensity of conditioning may be adjusted to the recipients biological status, which means that almost all patients with indications for allo-HCT may be offered this procedure. […] Chimeric antigen receptor (CAR) T-cells are genetically engineered T lymphocytes able to recognize and destroy cancer cells. Two products representing autologous CAR T-cells, tisagenlecleucel and brexucaptagene autoleucel have been approved for the treatment of relapsed/refractory B-ALL. Such therapy could potentially be offered to patients in CR1 with detectable MRD. In this clinical situation, CAR T-cells would be a final treatment, allowing to avoid allo-HCT. Clinical studies exploring this concept are ongoing.

• #99 6 Innovative Acute Lymphocytic Leukemia Treatment Options | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/acute-lymphocytic-leukemia/acute-lymphocytic-leukemia-treatment.html

  Maintenance: In the maintenance phase, patients receive a lower dose of chemotherapy to stop the cancer from returning. ALL patients receive maintenance chemotherapy for about two years. […] A stem cell transplant (also known as a bone marrow transplant) is a procedure that replaces cancerous bone marrow with new, healthy bone marrow stem cells. Stem cell transplants are usually given after an intense round of chemotherapy that kills the patients existing bone marrow cells and prepares the body for transplant. […] A stem cell transplant may be needed for patients whose leukemia has returned or has not responded to standard treatments. It may also be recommended if the patient has a high-risk form of leukemia that would make a cure with standard treatments unlikely. […] In Chimeric Antigen Receptor (CAR) T cell therapy, T cells are modified so they can recognize and attack cancer cells.

• #100 Medication for Acute Lymphoblastic Leukemia | NYU Langone Health

  https://nyulangone.org/conditions/acute-lymphoblastic-leukemia/treatments/medication-for-acute-lymphoblastic-leukemia

  During the consolidation phase of treatment, people with acute lymphoblastic leukemia receive additional chemotherapy to maintain a remission. A doctor may prescribe some of the same medications that were given during the induction phase. Consolidation may last for several months and is performed on an outpatient basis. The goal of consolidation is to destroy any minimal residual disease still in the body. […] During this phase, doctors may recommend an allogeneic stem cell transplant. A stem cell transplant involves the use of high intensity chemotherapy, with or without radiation therapy, to destroy the cancer. It can also support the immune system in mounting an attack against leukemia cells. It may especially benefit people with high levels of minimal residual disease or those with genetic changes that increase the risk of the cancer coming back after treatment with standard chemotherapy doses.

• #101 Acute lymphocytic leukemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acute-lymphocytic-leukemia/diagnosis-treatment/drc-20369083

  Depending on your situation, the phases of treatment for acute lymphocytic leukemia can span two to three years. […] Treatments may include: […] Chemotherapy, which uses drugs to kill cancer cells, is typically used as an induction therapy for children and adults with acute lymphocytic leukemia. Chemotherapy drugs can also be used in the consolidation and maintenance phases. […] Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die. Your leukemia cells will be tested to see if targeted therapy may be helpful for you. Targeted therapy can be used alone or in combination with chemotherapy for induction therapy, consolidation therapy or maintenance therapy. […] Radiation therapy uses high-powered beams, such as X-rays or protons, to kill cancer cells. If the cancer cells have spread to the central nervous system, your doctor may recommend radiation therapy.

• #102 Acute lymphoblastic leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Acute_lymphoblastic_leukemia

  Acute lymphoblastic leukemia is typically treated initially with chemotherapy aimed at bringing about remission. […] This is then followed by further chemotherapy typically over a number of years. […] Treatment usually also includes intrathecal chemotherapy since systemic chemotherapy can have limited penetration into the central nervous system and the central nervous system is a common site for relapse of acute lymphoblastic leukemia. […] Treatment can also include radiation therapy if spread to the brain has occurred. […] Stem cell transplantation may be used if the disease recurs following standard treatment. […] Additional treatments such as Chimeric antigen receptor T cell immunotherapy are being used and further studied. […] Possible treatments for acute leukemia include chemotherapy, steroids, radiation therapy, intensive combined treatments (including bone marrow or stem cell transplants), targeted therapy, and/or growth factors.

• #103 Acute Lymphoblastic Leukemia (ALL): Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/21564-acute-lymphocytic-leukemia

  Immunotherapy helps your bodys own immune system attack cancer cells. Immunotherapy for ALL may include CAR-T cell therapy or monoclonal antibody therapy. […] Healthcare providers may recommend radiation therapy to treat recurrent ALL or ALL that doesnt respond to chemotherapy. Recently, providers have used radiation therapy to treat ALL thats spread (metastasized) to peoples brains or spinal fluid. […] When other treatments havent eliminated ALL, a healthcare provider may recommend allogeneic stem cell (bone marrow) transplantation to treat adults with acute lymphoblastic leukemia.

• #104 Acute lymphoblastic leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Acute_lymphoblastic_leukemia

  Acute lymphoblastic leukemia is typically treated initially with chemotherapy aimed at bringing about remission. […] This is then followed by further chemotherapy typically over a number of years. […] Treatment usually also includes intrathecal chemotherapy since systemic chemotherapy can have limited penetration into the central nervous system and the central nervous system is a common site for relapse of acute lymphoblastic leukemia. […] Treatment can also include radiation therapy if spread to the brain has occurred. […] Stem cell transplantation may be used if the disease recurs following standard treatment. […] Additional treatments such as Chimeric antigen receptor T cell immunotherapy are being used and further studied. […] Possible treatments for acute leukemia include chemotherapy, steroids, radiation therapy, intensive combined treatments (including bone marrow or stem cell transplants), targeted therapy, and/or growth factors.

• #105 Acute Lymphoblastic Leukemia (ALL): Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/21564-acute-lymphocytic-leukemia

  Immunotherapy helps your bodys own immune system attack cancer cells. Immunotherapy for ALL may include CAR-T cell therapy or monoclonal antibody therapy. […] Healthcare providers may recommend radiation therapy to treat recurrent ALL or ALL that doesnt respond to chemotherapy. Recently, providers have used radiation therapy to treat ALL thats spread (metastasized) to peoples brains or spinal fluid. […] When other treatments havent eliminated ALL, a healthcare provider may recommend allogeneic stem cell (bone marrow) transplantation to treat adults with acute lymphoblastic leukemia.

• #106 Typical Treatment of Acute Lymphocytic Leukemia (ALL) | American Cancer Society

  https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/treating/typical-treatment.html

  If the leukemia goes into remission, the next phase often consists of another fairly short course of chemo, using many of the same drugs that were used for induction therapy. […] After consolidation, people generally get maintenance chemotherapy with methotrexate and 6-mercaptopurine (6-MP). […] In general, about 80% to 90% of adults will have complete remissions at some point during these treatments. […] If the leukemia is refractory that is, if it doesn’t go away with the first treatment (which happens in about 10% to 20% of people with ALL) then newer or more intensive doses of chemo drugs may be tried, although they are less likely to work. […] If leukemia goes into remission with the initial treatment but then comes back (relapses or recurs), it will most often do so in the bone marrow and blood. […] At some point, it may become clear that further treatment, even in clinical trials, is extremely unlikely to cure the leukemia. At this time, the focus of treatment may shift to controlling the leukemia and its symptoms for as long as possible, rather than trying to cure it.

• #107 Acute lymphoblastic leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Acute_lymphoblastic_leukemia

  Selection of biological targets based on their combinatorial effects on the leukemic lymphoblasts can lead to clinical trials for improvement in the effects of ALL treatment. […] Chimeric antigen receptors (CARs) have been developed as a promising immunotherapy for ALL. […] In trials these have been a type of T-cell capable of cytotoxicity. […] Typically, people who experience a relapse in their ALL after initial treatment have a poorer prognosis than those who remain in complete remission after induction therapy.

• #108 Acute Lymphoblastic Leukemia Treatment – NCI

  https://www.cancer.gov/types/leukemia/patient/adult-all-treatment-pdq

  Treatment of ALL during the post-remission phase includes: chemotherapy, targeted therapy with dasatinib, imatinib, or nilotinib, chemotherapy with stem cell transplant, central nervous system (CNS prophylaxis) including chemotherapy (intrathecal and/or systemic) with or without radiation therapy to the brain. […] Treatment of recurrent ALL may include: combination chemotherapy followed by stem cell transplant, immunotherapy (blinatumomab or inotuzumab ozogamicin) followed by stem cell transplant, low-dose radiation therapy as palliative care to relieve symptoms and improve quality of life, targeted therapy with dasatinib or revumenib for certain patients, CAR T-cell therapy (brexucabtagene autoleucel or tisagenlecleucel) for certain patients.

• #109 Acute Lymphoblastic Leukemia Treatment (PDQ®) – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65727/

  Patients with ALL who experience a relapse after chemotherapy and maintenance therapy are unlikely to be cured by further chemotherapy alone. These patients should be considered for reinduction chemotherapy followed by allogeneic BMT. […] Blinatumomab is a bispecific antibody targeting CD19 and CD3. The U.S. Food and Drug Administration (FDA) has approved blinatumomab for use in patients with relapsed or refractory B-cell ALL. […] Inotuzumab ozogamicin is an antibody-drug conjugate targeting CD22, which contains a conjugated toxin, calicheamicin. The FDA has approved inotuzumab ozogamicin for use in patients with relapsed or refractory B-cell ALL with CD22 expression. […] Patients with Ph-positive ALL are often taking imatinib at the time of relapse and thus have imatinib-resistant disease. Dasatinib is a novel tyrosine kinase inhibitor with efficacy against several different imatinib-resistant BCR::ABL1 fusion gene variants. Dasatinib has been approved for use in patients with Ph-positive ALL who are resistant to, or intolerant of, imatinib. […] Revumenib is an oral menin inhibitor that is approved by the FDA for the treatment of relapsed or refractory acute leukemia with a KMT2A translocation in adult and pediatric patients aged 1 year and older.

• #110 Acute Lymphoblastic Leukemia Treatment – NCI

  https://www.cancer.gov/types/leukemia/patient/adult-all-treatment-pdq

  Treatment of ALL during the post-remission phase includes: chemotherapy, targeted therapy with dasatinib, imatinib, or nilotinib, chemotherapy with stem cell transplant, central nervous system (CNS prophylaxis) including chemotherapy (intrathecal and/or systemic) with or without radiation therapy to the brain. […] Treatment of recurrent ALL may include: combination chemotherapy followed by stem cell transplant, immunotherapy (blinatumomab or inotuzumab ozogamicin) followed by stem cell transplant, low-dose radiation therapy as palliative care to relieve symptoms and improve quality of life, targeted therapy with dasatinib or revumenib for certain patients, CAR T-cell therapy (brexucabtagene autoleucel or tisagenlecleucel) for certain patients.

• #111 Acute Lymphoblastic Leukemia Treatment (PDQ®) – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65727/

  Patients with ALL who experience a relapse after chemotherapy and maintenance therapy are unlikely to be cured by further chemotherapy alone. These patients should be considered for reinduction chemotherapy followed by allogeneic BMT. […] Blinatumomab is a bispecific antibody targeting CD19 and CD3. The U.S. Food and Drug Administration (FDA) has approved blinatumomab for use in patients with relapsed or refractory B-cell ALL. […] Inotuzumab ozogamicin is an antibody-drug conjugate targeting CD22, which contains a conjugated toxin, calicheamicin. The FDA has approved inotuzumab ozogamicin for use in patients with relapsed or refractory B-cell ALL with CD22 expression. […] Patients with Ph-positive ALL are often taking imatinib at the time of relapse and thus have imatinib-resistant disease. Dasatinib is a novel tyrosine kinase inhibitor with efficacy against several different imatinib-resistant BCR::ABL1 fusion gene variants. Dasatinib has been approved for use in patients with Ph-positive ALL who are resistant to, or intolerant of, imatinib. […] Revumenib is an oral menin inhibitor that is approved by the FDA for the treatment of relapsed or refractory acute leukemia with a KMT2A translocation in adult and pediatric patients aged 1 year and older.

• #112 Treating Acute Lymphocytic Leukemia (ALL) | American Cancer Society

  https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/treating.html

  In most cases ALL can progress quickly if not treated, so it’s important to start treatment as soon as possible after the diagnosis is made. […] Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to get state-of-the-art cancer treatment. […] You may hear about alternative or complementary methods to relieve symptoms or treat your cancer that your doctors haven’t mentioned. […] Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known (or not known) about the method, which can help you make an informed decision. […] People with cancer need support and information, no matter what stage of illness they may be in. Knowing all of your options and finding the resources you need will help you make informed decisions about your care.

• #113 Treatment for acute lymphoblastic leukaemia (ALL leukemia) | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/leukaemia/acute-lymphoblastic-leukaemia-all-treatment

  Sometimes ALL comes back after a remission. This is called a relapse. If you relapse, it may be possible to have more treatment with chemotherapy, targeted or immunotherapy drugs, or CART-T cell therapy. The aim is to get a second remission. […] Some people will have a further treatment called a stem cell transplant once they are in remission. This can help reduce the risk of relapse in some situations. […] Treatment for ALL usually has to start quickly. If you do not feel ready to make a decision, ask your doctor how long you can have to think about it. […] Treatment that aims to cure the leukaemia may involve some disadvantages such as: longer stays in hospital usually for several weeks at a time, short-term side effects that may need treatment, a risk of permanent side effects such as infertility.

• #114 Acute Lymphocytic Leukemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459149/

  All blood products must be irradiated prior to transfusion to prevent transfusion-related graft versus host disease, which is universally fatal. […] Splenectomy is rarely required for acute lymphocytic leukemia. Splenectomy can help boost platelet count but does not affect the outcome of leukemia itself. Splenectomy can be performed for severe symptoms that are not amenable to chemotherapy treatment, such as abdominal pain. Radiation can also be used in cases of enlarged spleen to try and reduce the size of the spleen in most cases. […] Tumor lysis syndrome is a life-threatening complication that occurs in patients receiving chemotherapy. It is characterized by hyperuricemia, elevated potassium and phosphate, and decreased levels of calcium. Renal failure is invariably present.

• #115 Treatments for acute lymphoblastic leukemia | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/acute-lymphoblastic-leukemia-all/treatment

  Acute lymphoblastic leukemia (ALL) is sometimes treated with immunotherapy. It helps strengthen the immune system to fight cancer. […] A stem cell transplant replaces stem cells. Acute lymphoblastic leukemia (ALL) is sometimes treated with a stem cell transplant. […] Supportive therapy is given to treat the complications of leukemia and its treatments. […] Follow-up is an important part of care for acute lymphoblastic leukemia (ALL). It often involves regular tests and visits with the healthcare team.

• #116 Acute Lymphoblastic Leukemia (ALL) | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/acute-lymphoblastic-leukemia

  ALL often recurs in the cerebrospinal fluid the fluid that bathes the spinal column and brain. To prevent this, chemotherapy is injected directly into the cerebrospinal fluid. This is done by inserting a needle between the vertebrae of the lower back called a spinal tap or lumbar puncture and infusing chemotherapy directly into the clear cerebrospinal fluid. This procedure is called intrathecal chemotherapy. […] […] ALL patients are prone to viral infections and to a pneumonia called pneumocystis during their treatment. Antibiotics, such as acyclovir and Septra or Bactrim, are given during ALL therapy to help prevent these infections. […] […] Stem cell transplantation, also called blood or marrow transplantation (BMT), is only performed in patients who have abnormal cytogenetics (chromosome testing) or other features of high-risk ALL. Cytogenetics is the most important factor in deciding whether a person should have a bone marrow transplant for ALL. Patients with the Philadelphia chromosome or with the translocation involving chromosomes 4 and 11, should go on to BMT. […]

• #117 Acute Lymphocytic Leukemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459149/

  All blood products must be irradiated prior to transfusion to prevent transfusion-related graft versus host disease, which is universally fatal. […] Splenectomy is rarely required for acute lymphocytic leukemia. Splenectomy can help boost platelet count but does not affect the outcome of leukemia itself. Splenectomy can be performed for severe symptoms that are not amenable to chemotherapy treatment, such as abdominal pain. Radiation can also be used in cases of enlarged spleen to try and reduce the size of the spleen in most cases. […] Tumor lysis syndrome is a life-threatening complication that occurs in patients receiving chemotherapy. It is characterized by hyperuricemia, elevated potassium and phosphate, and decreased levels of calcium. Renal failure is invariably present.

• #118 Acute Lymphoblastic Leukemia (ALL) | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/acute-lymphoblastic-leukemia

  ALL often recurs in the cerebrospinal fluid the fluid that bathes the spinal column and brain. To prevent this, chemotherapy is injected directly into the cerebrospinal fluid. This is done by inserting a needle between the vertebrae of the lower back called a spinal tap or lumbar puncture and infusing chemotherapy directly into the clear cerebrospinal fluid. This procedure is called intrathecal chemotherapy. […] […] ALL patients are prone to viral infections and to a pneumonia called pneumocystis during their treatment. Antibiotics, such as acyclovir and Septra or Bactrim, are given during ALL therapy to help prevent these infections. […] […] Stem cell transplantation, also called blood or marrow transplantation (BMT), is only performed in patients who have abnormal cytogenetics (chromosome testing) or other features of high-risk ALL. Cytogenetics is the most important factor in deciding whether a person should have a bone marrow transplant for ALL. Patients with the Philadelphia chromosome or with the translocation involving chromosomes 4 and 11, should go on to BMT. […]

• #119 Acute Lymphocytic Leukemia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459149/

  All blood products must be irradiated prior to transfusion to prevent transfusion-related graft versus host disease, which is universally fatal. […] Splenectomy is rarely required for acute lymphocytic leukemia. Splenectomy can help boost platelet count but does not affect the outcome of leukemia itself. Splenectomy can be performed for severe symptoms that are not amenable to chemotherapy treatment, such as abdominal pain. Radiation can also be used in cases of enlarged spleen to try and reduce the size of the spleen in most cases. […] Tumor lysis syndrome is a life-threatening complication that occurs in patients receiving chemotherapy. It is characterized by hyperuricemia, elevated potassium and phosphate, and decreased levels of calcium. Renal failure is invariably present.

• #120 Acute Lymphoblastic Leukemia (ALL) Treatment | St. Jude Care & Treatment

  https://www.stjude.org/care-treatment/treatment/childhood-cancer/leukemia-lymphoma/acute-lymphoblastic-leukemia-all.html

  Our clinical trials are based on years of experience and success. We have helped set the standard for ALL treatment, advancing cure rates, and improving the understanding of the disease. […] Our team includes doctors trying to cure the disease and experts in nutrition, rehabilitation, nursing, education, psychology, social work, and child life. This team supports each child through diagnosis, treatment, and recovery.

• #121

• #122 Acute Lymphoblastic Leukemia (ALL) Treatment | St. Jude Care & Treatment

  https://www.stjude.org/care-treatment/treatment/childhood-cancer/leukemia-lymphoma/acute-lymphoblastic-leukemia-all.html

  Our clinical trials are based on years of experience and success. We have helped set the standard for ALL treatment, advancing cure rates, and improving the understanding of the disease. […] Our team includes doctors trying to cure the disease and experts in nutrition, rehabilitation, nursing, education, psychology, social work, and child life. This team supports each child through diagnosis, treatment, and recovery.

• #123 Treatments for acute lymphoblastic leukemia | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/acute-lymphoblastic-leukemia-all/treatment

  Your healthcare team will create a treatment plan just for you. The plan is based on your health and specific information about the cancer. What you want is also important when planning treatment. When deciding which treatments to offer for acute lymphoblastic leukemia (ALL), your healthcare team will consider: […] Chemotherapy is the main treatment for ALL. Targeted therapy and radiation therapy are sometimes used to treat ALL as well. […] If ALL relapses or doesn’t respond to treatment (called refractory ALL), immunotherapy including monoclonal antibodies may be used. A stem cell transplant may also be given with immunotherapy or used as a treatment on its own. […] Treatment for ALL is different for adults than it is for children. […] Induction treatments for acute lymphoblastic leukemia (ALL) include chemotherapy, targeted therapy and CNS prophylaxis or treatment.

• #124 Treatment of Acute Lymphocytic Leukemia

  https://www.healthline.com/health/leukemia/acute-lymphocytic-leukemia-treatment-options

  Blinatumomab, for example, is a bispecific T-cell engager (BiTE) monoclonal antibody used in ALL. […] Current CAR T-cell medications used in ALL include: brexucabtagene autoleucel, tisgenlecleucel. […] Clinical trials are how experts determine the safety, efficacy, and application of emerging therapies. […] Overall, the 5-year survival rate in ALL is around 90% for children, with adult survival rates between 20% and 40%. […] ALL may require second-line treatments like targeted therapies, immunotherapy, radiation, or stem cell transplant. This is likely if ALL is treatment-resistant, accompanied by less favorable prognostic factors, or certain genetic features are present.

• #125 Acute Lymphoblastic Leukemia (ALL) Treatment | St. Jude Care & Treatment

  https://www.stjude.org/care-treatment/treatment/childhood-cancer/leukemia-lymphoma/acute-lymphoblastic-leukemia-all.html

  Your child’s oncologist will discuss treatment options with you. […] St. Jude has led the way in how the world treats childhood leukemia since the hospital opened in 1962. […] St. Jude patients with ALL have a 94% survival rate. […] St. Jude investigators showed that radiation can be safely omitted from the treatment of most patients with ALL. […] St. Jude researchers found that there are more than 30 subtypes of ALL. They are based on changes in genes and chromosomes in the leukemia cells. This finding has transformed treatment for ALL. Treatment plans are now based on a child’s subtype and how it responds to specific treatments. […] At St. Jude, children with ALL can take part in clinical trials if they choose. These studies use the most advanced treatments available. Our goal is to improve each child’s chance of cure and to reduce the side effects of treatment.

• #126 Acute lymphocytic leukemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acute-lymphocytic-leukemia/diagnosis-treatment/drc-20369083

  Older adults, such as those older than 65, tend to experience more complications from treatments. And older adults generally have a worse prognosis than children who are treated for acute lymphocytic leukemia. […] Some people may choose to forgo treatment for the cancer, instead focusing on treatments that improve their symptoms and help them make the most of the time they have remaining.

• #127 Acute lymphoblastic leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Acute_lymphoblastic_leukemia

  Chemotherapy is the initial treatment of choice, and most people with ALL receive a combination of medications. […] In general, cytotoxic chemotherapy for ALL combines multiple antileukemic drugs tailored to each person. […] Adult chemotherapy regimens mimic those of childhood ALL; however, are linked with a higher risk of disease relapse with chemotherapy alone. […] Recent updates on the treatment of adult acute lymphoblastic leukemia (ALL) include advancements in immunotherapy, particularly the use of monoclonal antibodies like blinatumomab and inotuzumab ozogamicin, which target specific cancer cells and are used alongside stem cell transplantation. […] Radiation therapy (or radiotherapy) is used on painful bony areas, in high disease burdens, or as part of the preparations for a bone marrow transplant (total body irradiation).

• #128 Acute lymphocytic leukemia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/acute-lymphocytic-leukemia/diagnosis-treatment/drc-20369083

  Older adults, such as those older than 65, tend to experience more complications from treatments. And older adults generally have a worse prognosis than children who are treated for acute lymphocytic leukemia. […] Some people may choose to forgo treatment for the cancer, instead focusing on treatments that improve their symptoms and help them make the most of the time they have remaining.

• #129 Acute lymphoblastic leukemia – Wikipedia

  https://en.wikipedia.org/wiki/Acute_lymphoblastic_leukemia

  Chemotherapy is the initial treatment of choice, and most people with ALL receive a combination of medications. […] In general, cytotoxic chemotherapy for ALL combines multiple antileukemic drugs tailored to each person. […] Adult chemotherapy regimens mimic those of childhood ALL; however, are linked with a higher risk of disease relapse with chemotherapy alone. […] Recent updates on the treatment of adult acute lymphoblastic leukemia (ALL) include advancements in immunotherapy, particularly the use of monoclonal antibodies like blinatumomab and inotuzumab ozogamicin, which target specific cancer cells and are used alongside stem cell transplantation. […] Radiation therapy (or radiotherapy) is used on painful bony areas, in high disease burdens, or as part of the preparations for a bone marrow transplant (total body irradiation).

• #130 Acute Lymphoblastic Leukemia (ALL) Treatment Protocols: Treatment Protocols

  https://emedicine.medscape.com/article/2004705-overview

  For this reason, clinical trials are now ongoing to determine whether the prognosis of ALL in adults can be improved by giving pediatric-style regimens in the younger-adult population. […] Stem cell transplantation represents the most intensive postremission therapy and potentially increases a patient’s chance for cure. […] The prognosis for patients who experience relapse after front-line therapy is poor, with very few patients surviving long term. The best outcome is obtained if patients achieve a second remission and then proceed to allogeneic stem cell transplantation. […] Most of the chemotherapy regimens used for front-line therapy of ALL can be used in the salvage setting; however, response rates are low and remission durations are short. […] Blinatumomab, a bispecific T-cell engager (BiTE) antibody, is approved for Ph- relapsed or refractory B-cell ALL; treatment cycles consist of 4 wk continuous IV infusion with at least a 2-wk treatment-free interval between cycles. […] Three chimeric antigen receptor (CAR) T-cell therapies have been approved for treatment of relapsed or refractory B-cell precursor ALL.

• #131 How I treat newly diagnosed acute lymphoblastic leukemia | Published in Clinical Hematology International

  https://chi.scholasticahq.com/article/117026-how-i-treat-newly-diagnosed-acute-lymphoblastic-leukemia

  For patients with Ph- ALL, PIR is a standard of care. A meta-analysis of 25 studies comparing the results of pediatric protocols with those originally designed for adults showed an approximately 20% overall survival advantage at 5 years in favor of the pediatric ones in AYA. Direct implementation of pediatric protocols may be considered for patients up to 40 years old. The treatment intensity should be tapered for individuals between 40 and 55 years old. For those aged 55 years or more, the therapy should be personalized and adjusted to the performance status and comorbidities. […] The treatment of adults with ALL traditionally consists of polychemotherapy. It includes several phases: a pre-treatment phase, mainly using glucocorticoids, followed by an induction phase, aimed at achieving complete remission (CR), and a consolidation phase to perpetuate the state of CR. Follow-up is either maintenance therapy or an allogeneic hematopoietic cell transplantation (allo-HCT), which is recommended for patients with a high estimated risk of disease recurrence.

• #132 Treating Acute Lymphocytic Leukemia (ALL) | American Cancer Society

  https://www.cancer.org/cancer/types/acute-lymphocytic-leukemia/treating.html

  In most cases ALL can progress quickly if not treated, so it’s important to start treatment as soon as possible after the diagnosis is made. […] Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to get state-of-the-art cancer treatment. […] You may hear about alternative or complementary methods to relieve symptoms or treat your cancer that your doctors haven’t mentioned. […] Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known (or not known) about the method, which can help you make an informed decision. […] People with cancer need support and information, no matter what stage of illness they may be in. Knowing all of your options and finding the resources you need will help you make informed decisions about your care.

• #133 6 Innovative Acute Lymphocytic Leukemia Treatment Options | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/acute-lymphocytic-leukemia/acute-lymphocytic-leukemia-treatment.html

  For ALL, CAR T cell therapy is a treatment option for patients who have been treated unsuccessfully with other therapies. […] MD Anderson offers multiple clinical trials for ALL. Many of these cannot be found anywhere else. Trials explore new drug combinations and new drugs, including targeted therapies and immunotherapies.

• #134 Use of CAR T-cell for acute lymphoblastic leukemia (ALL) treatment: a review study | Cancer Gene Therapy

  https://www.nature.com/articles/s41417-021-00418-1

  Induction therapy aims to destroy the leukemia cells (blast). Complete remission is achieved when there is no sign of leukemia cells in the blood and the bone marrow after the treatment and normal hematopoiesis is restored. In the consolidation phase, the treatment is intensified and lasts for several months to reduce the number of leukemia cells still in the body and to avert the relapse of the disease. […] In the past decade, immunotherapies involving endogenous T cells have emerged as a new strategy to treat r/r ALL and avoid chemotherapy resistance. […] The use of ligand or peptide to target the CAR-T is an area of development. […] Their incorporation into frontline adult ALL therapy, in concomitant or sequential strategies, may increase the cure rates to levels achieved in pediatric ALL and may reduce the need for prolonged intensive and maintenance chemotherapy.

• #135 Treatment for Acute Lymphocytic Leukemia (ALL) | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/leukemias/treatment/acute-lymphocytic-leukemia

  Our doctors are experienced in preventing or controlling central nervous system involvement. We may administer chemotherapy directly to the fluid around the spinal cord and brain. This procedure is called intrathecal chemotherapy. […] Our researchers are constantly pursuing new ways to treat ALL. These approaches can kill tumor cells directly, slow down the body’s production of substances that promote their growth, or enhance the immune response against the leukemia cells. […] Some of the newer combination chemotherapy approaches that were evaluating in adults are inspired by innovative treatments developed for children with ALL. These treatments may be more effective than existing standard therapies.

• #136 Use of CAR T-cell for acute lymphoblastic leukemia (ALL) treatment: a review study | Cancer Gene Therapy

  https://www.nature.com/articles/s41417-021-00418-1

  Induction therapy aims to destroy the leukemia cells (blast). Complete remission is achieved when there is no sign of leukemia cells in the blood and the bone marrow after the treatment and normal hematopoiesis is restored. In the consolidation phase, the treatment is intensified and lasts for several months to reduce the number of leukemia cells still in the body and to avert the relapse of the disease. […] In the past decade, immunotherapies involving endogenous T cells have emerged as a new strategy to treat r/r ALL and avoid chemotherapy resistance. […] The use of ligand or peptide to target the CAR-T is an area of development. […] Their incorporation into frontline adult ALL therapy, in concomitant or sequential strategies, may increase the cure rates to levels achieved in pediatric ALL and may reduce the need for prolonged intensive and maintenance chemotherapy.

• #137 Treatment for Acute Lymphocytic Leukemia (ALL) | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/leukemias/treatment/acute-lymphocytic-leukemia

  Our doctors are experienced in preventing or controlling central nervous system involvement. We may administer chemotherapy directly to the fluid around the spinal cord and brain. This procedure is called intrathecal chemotherapy. […] Our researchers are constantly pursuing new ways to treat ALL. These approaches can kill tumor cells directly, slow down the body’s production of substances that promote their growth, or enhance the immune response against the leukemia cells. […] Some of the newer combination chemotherapy approaches that were evaluating in adults are inspired by innovative treatments developed for children with ALL. These treatments may be more effective than existing standard therapies.

• #138 How I treat newly diagnosed acute lymphoblastic leukemia | Published in Clinical Hematology International

  https://chi.scholasticahq.com/article/117026-how-i-treat-newly-diagnosed-acute-lymphoblastic-leukemia

  For adults with Ph- ALL, conventional chemotherapy using PIR remains a standard of care. Allo-HCT from either MSD, MUD, MMUD or haploidentical donors should be considered for patients with high risk of relapse. Patients with B-ALL and detectable MRD should be treated with blinatumomab. In the future, the use of blinatumomab and/or InO in addition to first-line chemotherapy may become a new standard of care reducing the role of allo-HCT.

• #139 Use of CAR T-cell for acute lymphoblastic leukemia (ALL) treatment: a review study | Cancer Gene Therapy

  https://www.nature.com/articles/s41417-021-00418-1

  Currently, chemotherapy is considered, as the first line to confront ALL. […] With the advent of knowledge of immunotherapy and its associated methods, increased efficacy in the treatment of cancer was created. Especially, CAR T cell technology as an Immunotherapy-based strategy is suggested as an ideal candidate for ALL treatment.

• #140 Treatment for acute lymphoblastic leukaemia (ALL)

  https://www.cancerresearchuk.org/about-cancer/acute-lymphoblastic-leukaemia-all/treatment

  Your treatment depends on several factors. These include what type of ALL you have, the cytogenetics of your leukaemia, and where it is in your body. It also depends on your general health and age. […] The main treatment for acute lymphoblastic leukaemia (ALL) is chemotherapy. But you may also have targeted cancer drugs, immunotherapy, or a stem cell transplant. […] Treatment for ALL usually starts quite quickly after diagnosis. You usually have steroids followed by chemotherapy. Find out about these and other treatments you might have such as a targeted cancer drug or stem cell transplant. […] Treatment for ALL is divided into different phases: induction, consolidation, intensification and maintenance. […] Chemotherapy is the main treatment for acute lymphoblastic leukaemia (ALL).

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