Acute lymphoblastic leukemia, or ALL, is a cancer that affects white blood cells. It can happen to anyone at any age, but it is more common in children and teenagers. It is a very serious cancer, but thanks to newer treatments, more and more children with ALL are considered cured after their treatment.
The cancer starts in your bone marrow, the spongy center of most bones that makes red blood cells, white blood cells and platelets. Under normal conditions, your bone marrow makes a carefully calibrated number of each type of cell. But in ALL, immature cells called blasts overtake the bone marrow and crowd out healthy blood-forming cells.
If you have ALL, the first step in treatment is to make sure that all of the cancerous blasts are gone — a process called remission. This is usually done with chemotherapy medications that are designed to kill both the leukemia cells and healthy blood-forming cells. The drugs may be given in pill form, through an IV line or directly into the bloodstream. You will also receive weekly spinal taps to prevent the leukemia from entering your brain and spine, and you will need to stay in the hospital for one to two weeks during this phase.
After the induction phase, you move into a consolidation phase, which is followed by a maintenance phase. In the maintenance phase, you will continue to get chemotherapy but at a lower dose. During this stage, your doctor will also give you a drug called methotrexate that helps to protect your body’s normal cells from damage by the chemotherapy.
The maintenance phase lasts a few months and includes more low-dose chemotherapy, and radiation therapy to help protect your body’s normal cells from damage. This is followed by a stem cell transplant. This is a complicated procedure that involves getting healthy blood-forming cells from a donor and then infusing them into your body. The transplant is a last resort for people whose leukemia hasn’t responded to other treatments.
At Penn, we use a personalized approach to leukemia care. If you have a genetic abnormality known as the Philadelphia chromosome, which was discovered at Penn more than 50 years ago, we can design a treatment plan that’s tailored for your specific type of leukemia. This type of targeted treatment improves your chances of a complete remission and a longer survival.
