Hematologic Malignancies Program

Patient and Family Education

Adult Acute Lymphocytic Leukemia

Treatment Phases

There are two phases of treatment for adult acute lymphocytic leukemia. The first phase is called induction therapy. The purpose of induction therapy is to kill as many of the leukemia cells as possible and make patients go into remission (a condition in which the disease partially or completely disappears). Once in remission with no signs of leukemia, patients enter a second phase of treatment called continuation therapy, which tries to kill any remaining leukemia cells. A patient may receive chemotherapy for up to several years to stay in remission.

The choice of treatment for adult acute lymphocytic leukemia depends on whether the patient has been treated before and the current status of the disease:

Untreated

Untreated adult acute lymphocytic leukemia means that no treatment has been given except to treat symptoms. There are too many white blood cells in the blood and bone marrow, and there may be other signs and symptoms of leukemia. Treatment will probably be systemic chemotherapy. This may be intrathecal chemotherapy alone or combined with either radiation therapy to the brain or high doses of systemic chemotherapy to treat or prevent leukemia in the brain. Treatment may also include blood transfusions, antibiotics, and instructions to keep the body and teeth especially clean. Clinical trials are testing new drugs.

In Remission

Remission means that treatment has been given and that the number of white blood cells and other blood cells in the blood and bone marrow is normal. There are no signs or symptoms of leukemia. Treatment may be one of the following:

Clinical trials of short-term, high-dose chemotherapy followed by long-term, low-dose chemotherapy.
Clinical trials of allogeneic bone marrow transplantation in which diseased bone marrow is replaced with bone marrow from a donor.
Clinical trials of autologous bone marrow transplantation in which a patient’s own diseased bone marrow is removed, treated, and then replaced.
Intrathecal chemotherapy into the fluid surrounding the brain, used alone or combined with either radiation to the brain or high doses of systemic chemotherapy, to prevent leukemia cells from growing in the brain (central nervous system or CNS prophylaxis).

Recurrent/Refractory

Recurrent disease means that the leukemia has come back after going into remission. Refractory disease means that the leukemia has failed to go into remission following treatment. Radiation therapy may be given to reduce symptoms. Patients may also choose to take part in a clinical trial of bone marrow transplantation.

This page was last updated on: October 7, 2009.