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There are various treatment choices for acute lymphocytic leukemia (ALL). Which one may work best for you? It depends on a number of factors, such as:
Your age and overall health
Your subtype of ALL
Results of your lab tests
If the leukemia cells have gene or chromosome changes
If the leukemia is affecting the brain and spinal cord, spleen, or liver
Your personal needs and preferences
How well the leukemia responds to the first treatment
You may have questions and concerns about your treatment options. You may also want to know how you’ll feel and function after treatment, and if you’ll have to change your normal activities.
Your healthcare provider is the best person to answer your questions. He or she can tell you what your treatment choices are, how successful they’re expected to be, and what the risks and side effects are. Your healthcare provider may advise a specific treatment. Or he or she may offer more than one, and ask you to decide which one you’d like to use. It can be hard to make this decision. It is important to take the time you need to make the best decision for you.
Chemotherapy. This is the main way to treat ALL. The treatment uses medicines to kill cancer cells. Its goal is to kill the cancer cells and put the cancer into remission. Remission means there are no signs of cancer in the body. The medicines may be injected into your cerebrospinal fluid (CSF) to prevent cancer growth or to reach cancer cells around the brain and nervous system. This is called intrathecal chemotherapy. It’s also called central nervous system prophylaxis.
Radiation therapy. This type of therapy uses high-energy X-rays to kill cancer cells. It may be used to kill or prevent the spread of cancer in your nervous system. It may be used right before a stem cell transplant. In rare cases, it may be done to shrink a tumor.
Stem cell transplant with high-dose chemotherapy. If the normal doses of chemotherapy don't work, your doctor may need to give you very high doses of chemotherapy. These high doses can damage the stem cells in your bone marrow. Blood stem cells are the "starter" cells for new blood cells. In some cases before chemotherapy, the doctor removes some stem cells from a volunteer donor and freezes them. They are then given to you after treatment to restore your body's lost blood cells. This is called a stem cell transplant.
Targeted therapy. These are medicines that target abnormal proteins, such as those caused by the Philadelphia chromosome. The medicines include imatinib, dasatinib, and nilotinib. They may be helpful in treating ALL that has this chromosome. These medicines are taken daily as pills.
Researchers are always finding new ways to treat ALL. These new methods are tested in clinical trials. Talk with your healthcare provider to find out if there are any clinical trials you should consider.
At first, thinking about treatment options may seem overwhelming. Talk with your doctors, nurses, and loved ones. Make a list of questions. Consider the benefits and possible side effects of each option. Discuss your concerns with your healthcare providers before making a decision.
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