Acute Lymphoblastic Leukemia

Acute lymphoblastic leukemia/lymphoma (ALL), also called acute lymphocytic leukemia and acute lymphoid leukemia, is a type of blood cancer that starts with a change to a single cell in the bone marrow.

ALL is the most common type of leukemia in children but is the least common type in adults. Only one-quarter of ALL cases are diagnosed in people aged 20 or older. Some patients will have these cancerous blood cells in their blood or bone marrow (leukemia), while others will develop them mostly in tumor masses (lymphoma). Treatment for ALL is highly complex and intense, so it’s important to be treated at a specialized center with expertise in ALL.

Learning that you have ALL can be shocking and overwhelming. Things can move very quickly — you may go from being diagnosed to starting treatment in just a few hours or days. Fred Hutchinson Cancer Center experts offer comprehensive ALL care, including advanced treatments and new options that are available only through clinical trials. Our deep experience means the best treatment plan for you.

Fred Hutch: A Leader in Leukemia Treatment

Fred Hutch is a world leader in leukemia research. Our physicians and scientists pioneered a very important leukemia treatment — bone marrow transplant — and are constantly working on new therapies. We provide expert care, day after day, to make sure you have the best possible outcome.

Your First Appointment

From the first time you come to see us, your ALL team will begin getting to know you and your family. What are your questions? What are your concerns?  

At your first appointment, your hematologist-oncologist will explain your disease, including your subtype. They will tell you how it’s treated and which tests you need to help plan your care. Before you leave, your team will make sure you understand the next steps. 

Learn About ALL

Acute lymphoblastic leukemia (ALL) is one type of cancer of the bone marrow and blood.

In people with ALL, something goes wrong with a type of blood stem cell called a lymphoblast. Instead of maturing into fully functioning lymphocytes — important immune-system cells — the lymphoblasts multiply out of control, and they don’t die off like normal blood cells do.

Facts & Resources

Treatment for ALL

At Fred Hutch, we think of treatment as a collaborative effort. Your physician will explain all your options and recommend a treatment plan based on your ALL subtype and classification, as well as your health, lifestyle and personal preferences.

We offer comprehensive treatment plans that may include chemotherapy, targeted therapy, immunotherapy, bone marrow transplant or clinical trials. Access to clinical trials is one reason many people come to us for care.


ALL Care Team

At Fred Hutch, a team of dedicated people surrounds you and your family to give you the highest level of care and support. You will have a hematologist-oncologist and a registered nurse who are experienced in caring for people with ALL. 

You are the most important person on your care team. Our patients are at the center of everything we do.

Care Team

Our Approach to Treatment

The safest, most effective and most widely accepted therapies for cancer are known as the “standard of care.” For many patients, these therapies will be a large part of their treatment. At Fred Hutch, we provide all standard therapies for ALL. We know how to choose the right ones for you and how to deliver them to give you the best chance at a full recovery.

Our physicians and researchers are always asking how we can make ALL treatments more effective and reduce side effects as much as possible. This is why we do clinical trials (also called clinical studies). Through these studies, we are able to offer you therapies that aren’t offered everywhere. A therapy that is going through trials now may become the new standard of care tomorrow. 

Along with treating your cancer, a group of world-class professionals is here to support you. This team includes nurses, registered dietitians, physical therapists, social workers and psychologists. We use supportive care services to promote your physical, mental and emotional well-being. 

Dr. Ryan Cassaday, hematologist-oncologist, describes the treatment options for acute lymphoblastic leukemia (ALL).


Role of the Caregiver

When someone close to you is diagnosed with ALL, you might step into the role of caregiver. Being a caregiver can mean many things, from lending a hand with daily living tasks to helping with medical decisions. It can also mean dealing with your own emotions and stress. 

At Fred Hutch, caregivers are valuable members of a patient’s care team. We see every day that your presence and support make a difference. We know that what your friend or family member is going through affects you, too.

Part of our mission is to help you take care of yourself. Caring for yourself is good for your physical, mental and emotional health. It also helps you give your best to your loved one. Our social workers, Spiritual Health team and Patient and Family Resource Center staff are here to help support you.

Dr. Ryan Cassaday

“Our ALL team at Fred Hutch is one of only a very few clinical teams in the U.S. whose sole clinical charge is to treat this disease. ALL is both treatable and curable. So, despite what sounds like a very scary and intimidating diagnois, ALL is something that we can make go away forever."

— Ryan Cassaday, MD, hematologist-oncologist

Latest Treatments and Clinical Trials

Physicians and scientists from Fred Hutchinson Cancer Center and UW Medicine are testing new treatments for ALL and finding new ways to use current treatments. Through this work, we are looking for answers to two main questions: How can we do even better at controlling or curing ALL? How can we make treatments less toxic and easier on patients?

We have clinical trials for all classifications of ALL, from newly diagnosed to refractory. The trials are testing dozens of medicines, including:

  • Chemotherapy regimens
  • Targeted therapies
  • Immunotherapies, including cellular immunotherapies 

In the past 15 years, research on targeted therapies and immunotherapies has found new ways to put ALL into remission and make treatments less toxic for patients. Fred Hutch is a national leader in advancing these and other options, bringing new hope to patients.

When your care team designs your treatment plan, they will give you the choice to join clinical trials that match your situation. If you decide to join one, you will see the same physicians and nurses as you would for standard therapy.

Your care team will talk with you if you might want to join a particular study and why, so you can make the decision that’s best for you.

Related News

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Dr. Ajay Gopal named Stephen H. Petersdorf Endowed Chair in Cancer Care at UW Medicine Chair honors his dedication to improving patient care through research January 26, 2023
Leader in apheresis and cellular therapy, Dr. Michael Linenberger, retires As professor emeritus, this respected mentor will continue to contribute to the UW fellowship program December 16, 2022
A giant in BMT survivorship Dr. Mary Flowers steps down from leading Fred Hutch BMT Long-Term Follow-Up program December 15, 2022
New approach could make bone marrow transplantation safer, stronger Tests prevented relapse, limited GVHD in laboratory models of leukemia, multiple myeloma October 14, 2022