As with all cancers, treatment for acute lymphocytic leukemia (ALL) is usually coordinated by a cancer care team, headed by a primary care physician and/or medical oncologist. For children with ALL, specialists may include a hematologist, pediatric oncologist and radiation oncologist.

There are a variety of methods used to treat ALL in children. The exact treatment method chosen for each child depends on the risk group of the leukemia as well as certain prognostic factors including the child’s age and white blood cell count at the time of diagnosis. Children may receive one method of treatment or a combination of treatments.  

Since leukemia is a blood disorder and does not form tumors, surgery is not a form of treatment. Common treatment methods for ALL in children include:

• Chemotherapy. This treatment method uses powerful drugs to destroy cancer cells. It may also be used to prevent the cancer from spreading to the brain and spinal cord. When used to treat ALL, a combination of drugs is given to the child over a long period of time. Chemotherapy is the most common treatment method for ALL, and children tend to respond better to chemotherapy than adults.
  
  
• Radiation therapy. Radiation therapy uses high-energy rays to destroy cancer cells and shrink tumors. It may be ordered to treat leukemia that has spread to the brain, spinal fluid or testicles. On rare occasions, radiation treatment may be ordered as an emergency treatment to reduce the size of a mass pressing on the trachea.
  
  
• Bone marrow/stem cell transplantation. This method allows a child to receive high levels of chemotherapy, radiation or a combination of both. Although the high dose treatment destroys the leukemia cells, it also destroys normal blood cells in the bone marrow. After the treatment, the child receives an infusion of healthy stem cells through a vein. The stem cells may come from a matched donor or from the patients themselves. As a result, new blood cells begin to develop from the transplanted cells. This procedure is still fairly new and complex and cannot be used with all children.

Children with ALL will be treated according to the severity of their cancer. Since ALL is a cancer of the blood, the treatments are designed to treat the entire body. Chemotherapy is the primary treatment and provided in the following stages:

• Induction. This the most aggressive stage with the goal of destroying as many cancer cells as possible and putting the disease in remission. More than 95 percent of children with ALL will enter remission after the first month of treatment. The child usually receives a combination of chemotherapy drugs designed for the specific type of leukemia.
  
  
• Consolidation. During this phase, different types of drugs are given to destroy those cells that remain after the induction phase. This phase also focuses on preventing the spread of cancer cells to other areas, particularly the central nervous system (CNS). If cancer cells are noted in the spinal fluid at this time, the child may receive radiation therapy to the brain and spinal cord (part of the CNS).
  
  
• Maintenance. This is the last phase of treatment which may continue for two to three years. This part of treatment is less intensive and may consist mainly of medications (pills) given at home. Occasionally, the child may need to receive intravenous medications during this phase. The type of medication and dose will depend on the characteristics of the child’s cancer.

Usually, the total duration of therapy for most children with ALL is two to three years. After treatment a child will require regular visits to their physician for several years. Frequent checkups enable their physician to detect any changes in health and treat them immediately. Checkups may include a physical examination, x-rays, blood tests, and other lab tests.

Parents are encouraged to report the development of any new symptoms in their child to their physician. They may be a sign of recurrent ALL or side effects of treatment. If a relapse occurs, it typically occurs while the child is undergoing treatment, or within six months of completing treatment. The disease can come back in the blood, bone marrow, or other parts of the body. It is unusual for ALL to return if there are no signs of the disease two years after treatment. According to the American Cancer Society (ACS), the five-year survival rate for children with ALL is 87 percent. This high cure rate is mainly due to advancements in treatment.

Currently, there is no known method of preventing acute lymphocytic leukemia (ALL) in children because it is not linked to preventable lifestyle risk factors. Children with a known risk factor, such as Down syndrome or treatment with chemotherapy or radiation therapy, should receive regular medical check-ups. The earlier the disease is diagnosed, the earlier treatment may begin. In addition, pregnant women should always inform their physician before undergoing tests or medical procedures that involve radiation, including x-rays.