Acute Lymphoblastic Leukaemia

What are the treatment options for acute lymphoblastic leukaemia?

The primary treatment options for acute lymphoblastic leukaemia (ALL) include chemotherapy and targeted therapies. The type of treatment you receive will depend on a number of different considerations, such as your overall health and your treatment preferences. This page aims to give you a comprehensive overview of how acute lymphoblastic leukaemia treatment works in Malaysia.

Chemotherapy for acute lymphoblastic leukaemia

Chemotherapy is the primary treatment for ALL. It uses a range of drugs to kill and slow the growth of acute lymphoblastic leukaemia cells.

Learn more about chemotherapy and how it is delivered.

When treating acute lymphoblastic leukaemia, chemotherapy is delivered in three different therapy phases known as induction, consolidation and maintenance.

• Induction therapy – Usually delivered in a cycle of four to six weeks, induction therapy is an intense phase of treatment that aims to destroy as many abnormal white blood cells as possible. You will usually spend the duration of your induction treatment in the hospital, as well as some time afterwards, as this initial phase of treatment is very intensive and may cause infections and complications if not monitored closely

• Consolidation therapy – Consolidation therapy helps prevent the return of acute lymphoblastic leukaemia and uses a number of different drugs to destroy any remaining cancer cells. This phase takes place over a span of a few months

• Maintenance therapy – While this final step of chemotherapy treatment is rarely needed, maintenance therapy may be used over a span of two to three years. Similar to consolidation therapy, the aim is to prevent the return of ALL cells and is a less intense form of treatment compared to induction and consolidation therapies

Targeted therapies for acute lymphoblastic leukaemia

Targeted therapies use specialised drugs to destroy ALL cells by focusing on abnormalities found within cancer cells, while avoiding normal healthy cells. If the Philadelphia chromosome is present in your cancer cells, targeted therapies are usually used as the primary form of treatment. Targeted therapies may be delivered alone or in combination with other chemotherapy drugs.

Bone marrow transplant for acute lymphoblastic leukaemia

Bone marrow transplants, which are also referred to as stem cell transplants, replace cancerous bone marrow with healthy stem cells that help stimulate the development of new, healthy bone marrow. In order to destroy leukaemia-producing bone marrow, you will first receive high doses of chemotherapy before the healthy stem cells are transplanted.

Not all people with acute lymphoblastic leukaemia will require a bone marrow transplant. The need for transplant depends on the risk of relapse which is assessed on an individual basis related your condition, genetic features of the leukaemia and its response to treatment.

Bone marrow transplants for acute lymphoblastic leukaemia are done with cells donated from another person, this is known as an allogenic transplant. The donor must be a match to donate but may be a relative or an unrelated donor found through an international search. A bone marrow transplant involves giving high doses of chemotherapy with or without radiotherapy followed by the infusion of donor stem cells into your bloodstream.

Treatment by stage of acute lymphoblastic leukaemia

As the traditional cancer staging system is not used to stage ALL, treatment for acute lymphoblastic leukaemia instead focuses on long-term chemotherapy, usually lasting about two years. Chemotherapy treatment will be delivered in a three-phase approach: induction, consolidation and maintenance. In consolidation and maintenance, targeted therapy drugs may also be used depending on if your acute lymphoblastic leukaemia cells have the Philadelphia chromosome.