Untreated Childhood Acute Lymphoblastic Leukemia
Childhood Acute Lymphoblastic Leukemia Subgroups
Recurrent Childhood Acute Lymphoblastic Leukemia

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

Standard treatment of childhood acute lymphoblastic leukemia (ALL) during the induction, consolidation /intensification, and maintenance phases may include the following:

• Combination chemotherapy.
• CNS sanctuary therapy with intrathecal chemotherapy and/or radiation therapy to the brain.

Some of the treatments being studied in clinical trials for childhood ALL include the following:

• Combination chemotherapy with or without intrathecal chemotherapy. Radiation therapy to brain may also be given.
• Combination chemotherapy followed by stem cell transplant using stem cells donated by a brother or sister.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with untreated childhood acute lymphoblastic leukemia ¹.

Standard treatment of T-cell childhood acute lymphoblastic leukemia (ALL) is usually combination chemotherapy. CNS sanctuary therapy with intrathecal chemotherapy and/or radiation therapy to the brain may also be given. One of the treatments being studied in clinical trials for T-cell childhood ALL is a new kind of anticancer drug.

Treatment of infants with ALL is usually a clinical trial of systemic chemotherapy with intrathecal chemotherapy or chemotherapy followed by a donor stem cell transplant.

Treatment of ALL in older children and adolescents usually involves more aggressive therapy (stronger treatments and higher doses) than that given to children aged 1-9 years.

Standard treatment of Philadelphia chromosome -positive childhood ALL is usually a stem cell transplant using stem cells donated by a brother or sister. One of the treatments being studied in clinical trials for Philadelphia chromosome-positive childhood ALL is imatinib mesylate (Gleevec).

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with T-cell childhood acute lymphoblastic leukemia ² and Philadelphia chromosome positive childhood precursor acute lymphoblastic leukemia ³.

Standard treatment of recurrent childhood acute lymphoblastic leukemia (ALL) may include the following:

• Combination chemotherapy.
• Systemic chemotherapy and intrathecal chemotherapy with or without radiation therapy to the brain and spinal cord.
• Chemotherapy with stem cell transplant, using stem cells from a donor who is related to the patient, with or without total-body irradiation.
• Chemotherapy plus radiation therapy for cancer that recurs in the testicles only.

Some of the treatments being studied in clinical trials for recurrent childhood ALL include the following:

• A clinical trial of chemotherapy with stem cell transplant, using stem cells from a donor who is not related to the patient, with or without total-body irradiation.
• A clinical trial of new anticancer drugs and new combination chemotherapy treatments.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent childhood acute lymphoblastic leukemia ⁴.

Glossary Terms

ALL. A fast-growing type of leukemia (blood cancer) in which too many lymphoblasts (immature white blood cells) are found in the blood and bone marrow. Also called ALL and acute lymphocytic leukemia.

Treatment with drugs that kill cancer cells.

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called a clinical study.

Chemotherapy or radiation therapy given to the central nervous system (CNS) as a preventive treatment. It kills cancer cells that may be in the brain and spinal cord, even though no cancer has been detected there. Also called central nervous system sanctuary therapy, central nervous system prophylaxis, and CNS prophylaxis.

Treatment using more than one anticancer drug.

A type of high-dose chemotherapy often given as the second phase (after induction therapy) of a cancer treatment regimen for leukemia. Also called intensification therapy.

The amount of medicine taken, or radiation given, at one time.

Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.

A drug used to treat different types of leukemia and other cancers of the blood, gastrointestinal stromal tumors, skin tumors called dermatofibrosarcoma protuberans, and a rare condition called systemic mastocytosis. It is also being studied in the treatment of other types of cancer. Imatinib mesylate blocks the protein made by the bcr/abl oncogene. It is a type of tyrosine kinase inhibitor. Also called Gleevec and STI571.

Treatment designed to be used as a first step toward shrinking the cancer and in evaluating response to drugs and other agents. Induction therapy is followed by additional therapy to eliminate whatever cancer remains.

A type of high-dose chemotherapy often given as the second phase (after induction therapy) of a cancer treatment regimen for leukemia. Also called consolidation therapy.

Treatment in which anticancer drugs are injected into the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord.

Treatment that is given to help a primary (original) treatment keep working. Maintenance therapy is often given to help keep cancer in remission.

An abnormality of chromosome 22 in which part of chromosome 9 is transferred to it. Bone marrow cells that contain the Philadelphia chromosome are often found in chronic myelogenous leukemia.

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called radiotherapy and irradiation.

Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrence.

A column of nerve tissue that runs from the base of the skull down the back. It is surrounded by three protective membranes, and is enclosed within the vertebrae (back bones). The spinal cord and the brain make up the central nervous system, and spinal cord nerves carry most messages between the brain and the rest of the body.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

In medicine, treatment that experts agree is appropriate, accepted, and widely used. Health care providers are obligated to provide patients with standard therapy. Also called standard of care or best practice.

A cell from which other types of cells develop. For example, blood cells develop from blood-forming stem cells.

A method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells.

Treatment with anticancer drugs that travel through the blood to cells all over the body.

One type of white blood cell that attacks virus-infected cells, foreign cells, and cancer cells. T cells also produce a number of substances that regulate the immune response. Also called T lymphocyte.

One of two egg-shaped glands found inside the scrotum that produce sperm and male hormones. Also called a testis.

Treatment.

Radiation therapy to the entire body. It is usually followed by bone marrow or peripheral stem cell transplantation.