Treatment

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Consolidation

During the consolidation phase, a secondary treatment is given to kill any cancer cells that may be left in the body. Treatments may include radiation therapy, a stem cell transplant, or chemotherapy. This phase may last several months.

Maintenance

During the maintenance phase, patients may receive lower doses of drugs but for long periods of time -- typically for two years -- to destroy any remaining leukemia cells that have evaded the drugs already used; these cells are usually not be detectable by laboratory tests. Commonly used drugs for maintenance include methotrexate, 6-mercaptopurine, vincristine, and prednisone.

Treatment for Ph-Positive ALL

Between 20 and 30 percent of adult ALL patients have a chromosomal abnormality called the Philadelphia chromosome and a type of ALL called Ph-positive (or Philadelphia-positive). These patients may receive a drug called imatinib mesylate (Gleevec^®), or related drugs, such as dasatinib (Sprycel^®) or nilotinib (Tasigna^®) in combination with other chemotherapeutic drugs.

Treatment for Central Nervous System Involvement

ALL sometimes spreads to the central nervous system, which is the part of the nervous system that consists of the brain and the spinal cord. Physicians treat most patients to prevent or control central nervous system involvement and may administer chemotherapy directly to the fluid that bathes the spinal cord and brain in a process known as intrathecal chemotherapy. Patients may receive high-dose systemic chemotherapy or cranial irradiation (radiation therapy to the head) to prevent the spread of disease to the central nervous system.

For some patients with ALL, a bone marrow or stem cell transplant may be part of the treatment plan. For more information on transplantation, visit our transplant section on the Web site.

Our Clinical Trials Find out about new clinical trials for leukemia more

Researchers at Memorial Sloan-Kettering continue to develop new agents for cancer treatment. Relying, in part, on the information that is emerging about the genetic basis of leukemia, investigators are pursuing a variety of strategies to control the disease -- approaches that can kill tumor cells directly, inhibit the body's production of substances that promote their growth, or enhance the immune response against leukemic cells.

• Cancer Genetics

  Researchers here are studying the chromosomal abnormalities in patients with untreated ALL to better predict how patients with particular genetic attributes will respond to treatment. The results could help them link specific karyotypes (the number and structure of chromosomes in an individual) with multidrug resistance, help identify new chromosome abnormalities that play a role in the development of leukemia, and correlate specific genetic abnormalities with toxic exposures and family histories.

• New Combination Chemotherapy

  Drugs used in chemotherapy work in different ways to stop tumor cells from dividing and to cause them to die. Physicians usually combine two or more agents in a course of treatment in an effort to kill as many tumor cells as possible. Investigators at Memorial Sloan-Kettering are comparing the effectiveness of various combinations of chemotherapeutic agents.

• Engineered T Cells

  Researchers at Memorial Sloan-Kettering are working to produce T cells, a form of white blood cell, that will recognize and attack a patient's cancer cells. To do this, they extract some of the patient's own T cells, introduce a gene that enables these cells to recognize a protein on the surface of the leukemia cells, and grow these cells in culture before giving them back to the patient. The modified T cells, now able to recognize the antigens as foreign, should divide and multiply until they reach numbers that can have an impact on the tumor cells. Investigators then administer the "engineered" T cells back into the patient so that they will seek out and destroy the cancer cells.