Treatment Options for Childhood Acute Lymphoblastic Leukemia

Newly Diagnosed Childhood Acute Lymphoblastic Leukemia (Standard Risk)
Newly Diagnosed Childhood Acute Lymphoblastic Leukemia (High Risk)
        T-cell childhood acute lymphoblastic leukemia
        Infants with ALL
        Children and teenagers with ALL
        Philadelphia chromosome-positive ALL
Recurrent Childhood Acute Lymphoblastic Leukemia

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your child's doctor for clinical trials that are not listed here but may be right for your child.

Treatment of standard-risk childhood acute lymphoblastic leukemia (ALL) during the induction, consolidation /intensification, and maintenance phases may include the following:

• Combination chemotherapy.
• Combination chemotherapy followed by stem cell transplant using stem cells from a donor.
• A clinical trial of a new chemotherapy regimen.
• A clinical trial of a new combination chemotherapy and intrathecal chemotherapy regimen given with or without radiation therapy and/or stem cell transplant. The chemotherapy dose and/or schedule depends on the patient's risk group after induction therapy.

CNS-directed therapy to treat or prevent the spread of leukemia cells to the brain and spinal cord may include the following:

• Intrathecal chemotherapy.
• High-dose systemic chemotherapy.
• Radiation therapy.
• A clinical trial of a new anticancer drug, the doses of certain anticancer drugs, and the use of radiation therapy to the brain.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with untreated childhood acute lymphoblastic leukemia. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Treatment of T-cell childhood acute lymphoblastic leukemia (ALL) may include the following:

• Combination chemotherapy.
• A clinical trial of a new chemotherapy regimen.

CNS-directed therapy to treat or prevent the spread of leukemia cells to the brain and spinal cord may include the following:

• Intrathecal chemotherapy.
• High-dose systemic chemotherapy.
• Radiation therapy.
• A clinical trial of a new anticancer drug, the doses of certain anticancer drugs, and the use of radiation therapy to the brain.

Treatment of infants with ALL may include the following:

• Combination chemotherapy.
• Chemotherapy followed by a donor stem cell transplant has been studied but it is not clear if this treatment improves survival.
• A clinical trial of chemotherapy followed by a donor stem cell transplant for infants with certain gene changes.
• A clinical trial of combination chemotherapy and targeted therapy with a tyrosine kinase inhibitor.

CNS-directed therapy to treat or prevent the spread of leukemia cells to the brain and spinal cord may include the following:

• Intrathecal chemotherapy.
• High-dose systemic chemotherapy.

Treatment of ALL in children and teenagers (10 years and older) may include the following:

• Combination chemotherapy.
• A clinical trial of a new combination chemotherapy regimen.
• A clinical trial of a new anticancer drug, new doses of certain anticancer drugs, and the use of radiation therapy to the brain. The chemotherapy dose and/or schedule depends on the patient's risk group after induction therapy.

CNS-directed therapy to treat or prevent the spread of leukemia cells to the brain and spinal cord may include the following:

• Intrathecal chemotherapy.
• High-dose systemic chemotherapy.
• Radiation therapy.
• A clinical trial of a new intrathecal chemotherapy and high-dose systemic chemotherapy regimen and the use of radiation therapy.

Treatment of Philadelphia chromosome -positive childhood ALL may include the following:

• Combination chemotherapy followed by targeted therapy with a tyrosine kinase inhibitor (imatinib mesylate).
• Combination chemotherapy followed by stem cell transplant using stem cells from a donor.
• A clinical trial of combination chemotherapy and a new tyrosine kinase inhibitor, with or without stem cell transplant.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with T-cell childhood acute lymphoblastic leukemia and Philadelphia chromosome positive childhood precursor acute lymphoblastic leukemia. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.

Standard treatment of recurrent childhood acute lymphoblastic leukemia (ALL) for leukemia that comes back in the bone marrow may include the following:

• Combination chemotherapy.
• Chemotherapy with or without total-body irradiation followed by a stem cell transplant, using stem cells from a donor.

Standard treatment of recurrent childhood acute lymphoblastic leukemia (ALL) for leukemia that comes back outside the bone marrow may include the following:

• Chemotherapy and radiation therapy for cancer that comes back in the testicles only.
• Combination chemotherapy and intrathecal chemotherapy with radiation therapy to the brain and/or spinal cord for cancer that comes back in the brain and spinal cord only.

Some of the treatments being studied in clinical trials for recurrent childhood ALL include the following:

• New anticancer drugs and new combination chemotherapy treatments.
• Combination chemotherapy and new kinds of targeted therapies.

Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent childhood acute lymphoblastic leukemia. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.