Acute lymphocytic leukemia is a fast-growing cancer of the blood and bone marrow, where blood cells are made. It affects immature blood cells and white blood cells called lymphocytes. MayoClinic.com states that this leukemia is the most common type of childhood cancer; however, it also occurs in adults. Symptoms include frequent infections, easy bruising, fatigue, low-grade fevers, nose bleeds and swollen lymph glands. Treatment for acute lymphocytic leukemia, also known as ALL, is typically administered in phases.
Induction Chemotherapy
High doses of chemotherapy drugs are used to kill cancer cells in the blood and bone marrow during the induction phase. According to MayoClinic.com, chemotherapy is the most common form of treatment in the induction phase for children and adults. In addition to killing cancer cells, chemotherapy drugs also kill normal cells, which can cause anemia, infection and bleeding. Induction therapy is used to bring the cancer into remission. Remission occurs when blood counts return to normal and cancer is no longer detected in the bone marrow samples.
Some chemotherapy medications are given by mouth and others are given through a catheter in the vein. Most patients are treated with a combination of chemotherapy drugs such as methotrexate, dexamethasone, daunorubicin, cyclphosphamide and vincristine. Side effects of chemotherapy include hair loss, fatigue, weight changes, appetite loss, diarrhea, constipation, cognitive changes and damage to the heart, liver, lungs and kidneys.
Consolidation Therapy
After the induction phase, consolidation therapy is needed. Consolidation therapy lasts a few months and aims to kill cancer cells that may not show up in blood tests and bone marrow biopsies. The Leukemia and Lymphoma Society states that all patients who are in remission should have treatment for cancer cells that are in the lining of the spinal cord and brain to prevent leukemia of the central nervous system. Chemotherapy is usually injected into the spinal fluid because chemotherapy drugs given by mouth or in a vein do reach the lining of the spinal cord and brain.
Maintenance Therapy
Maintenance therapy can last up to three years during which time chemotherapy drugs are usually given in low doses to prevent the leukemia from reoccurring.
Radiation Therapy
In some cases, leukemia cells have spread to the brain and spinal cord. Radiation therapy is necessary for treatment. Radiation therapy uses high energy beams and X-rays to kill cancer cells and prevent them from multiplying. Common side effects of radiation include skin changes, fatigue, nausea, vomiting, diarrhea and hair loss in the area being treated.
Bone Marrow Transplant
Patients at high risk of relapse may receive a bone marrow transplant as consolidation therapy. Bone marrow transplants are also used in some patients who have had leukemia return. During a bone marrow transplant, high doses of chemotherapy and radiation are given to kill the patient's bone marrow. Healthy marrow from another person who has compatible marrow replaces the patient's marrow. In some cases, the patient's own marrow is harvested while in remission and used during bone marrow transplant. During a bone marrow transplant, a patient feels very sick. Extreme weakness, vomiting, fever, nausea and diarrhea are common side effects.
