Acute Lymphocytic Leukemia (ALL)

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Chemotherapy

If your child has leukemia, your child’s doctors will recommend one or a combination of therapies. These can include chemotherapy, radiation therapy, and bone marrow transplantation.

Chemotherapy uses anti-cancer drugs that can be given to children intravenously, by mouth, directly into the spinal fluid, or as a shot in the leg. These medicines are distributed throughout the body through the bloodstream. They can help kill cancer cells that are in the blood and bone marrow as well as those that may have spread to other areas. Chemotherapy is the primary treatment for childhood ALL.

Children with leukemia usually receive chemotherapy for six to nine months, and all the therapy is given in the hospital. Researchers are studying new combinations of chemotherapy drugs in order to find the most effective combinations for different types of leukemia.

There are four phases to chemotherapy treatment:

  • The first phase is called Remission Induction. Treatment during this phase is designed to kill the leukemic cells in the blood and the bone marrow, putting the disease into remission.
  • The second phase is Central Nervous System Directed Therapy. This phase kills cancer cells in the central nervous system and prevents the disease from spreading to the spinal fluid.
  • The Consolidation/Intensification phase is given after the disease is considered to be in remission. It's designed to kill remaining leukemic cells that may be inactive but could begin growing again and cause the leukemia to recur. This phase usually lasts several months.
  • The maintenance phase is the final phase of treatment that lasts for two to three years. It's used to kill any remaining cells that could cause a recurrence. Medications are often given at lower doses.

Leukemia can spread to other places in the body: the central nervous system or, in boys, the testicles. If there is evidence of leukemia in these areas, your child will receive chemotherapy and radiation therapy to the brain and spinal cord or testicles. All patients with leukemia receive chemotherapy directly into the spinal fluid. This is to keep the leukemia from spreading there or treat the leukemia if it is already in the spinal fluid.

Side Effects

Side effects of chemotherapy will be different from person to person. They can include fatigue, nausea, vomiting, diarrhea, loss of appetite, and risk of infection. Your doctor will provide medications to lessen these side effects. Be sure to ask your doctor questions about which medications are being prescribed for your child, what the side effects may be, and what interactions may occur with other medications your child may be taking.