Today, there are more treatment options than ever before to put ALL into remission. Unlike many other cancers, ALL is both treatable and curable, so there’s plenty of reason for hope.
Our ALL specialists work closely with you, your family and each other to help get you back to health. At Fred Hutchinson Cancer Center, we provide all available standard therapies for ALL as well as targeted therapy, immunotherapy and bone marrow transplants. We also offer you access to the latest treatments through clinical trials.
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.
Treatment Plan | Treatment Process | Monitoring Your Health | Supportive Care Services | Continuing Care
Treatment for ALL is different for each person. When it comes to treatment options, we think about every detail of your disease, from type to subtype, along with your goals and priorities.
Fred Hutch offers medical oncologists and hematologists who specialize in ALL . We offer the most advanced diagnostic, treatment and recovery programs, as well as extensive, holistic support.
We think about treatment as a collaborative effort. Your Fred Hutch physician will explain all your options and recommend a treatment plan based on your ALL subtype and classification, health, lifestyle and preferences.
Your personal team includes a hematologist-oncologist, advanced practice provider, nurse case manager and patient care coordinator. Other experts who specialize in treating people with cancer will join your team if needed. Our team approach means you can easily get help from experts like an infectious disease physician, pulmonologist, palliative care professional, geneticist, social worker, physical therapist or registered dietitian.
With support from the larger team, your physician will:
You are part of the care team, too. Your hematologist-oncologist will talk with you and your caregiver about your personal preferences and each of your options. We decide how to move forward together.
For ALL, treatment plans are different from person to person. The treatment plan we design for you depends on many things, including:
Different subtypes of ALL progress and respond to treatments in different ways. We choose, combine and schedule your treatments based on what works for your subtype and how your body responds. Your care team will make sure you understand each type of treatment and all of your choices.
Treatment for ALL is highly complex and intense. It is usually done in three phases.
Most people with ALL start by getting intense chemotherapy and follow up with more treatments of phased chemotherapy.
Chemotherapy uses medicines to kill fast-growing cells (like cancer cells) or to keep them from dividing (which is how cancers grow). Chemotherapy drugs are usually given through an intravenous (IV) line in repeating cycles every two to six weeks.
Your care team will talk with you about which drugs we recommend for you, how you will take them, your treatment schedule and what to expect. We will also explain how to take the best possible care of yourself during treatment and after, and we’ll connect you with medical and support resources throughout Fred Hutch.
Some of the chemotherapy drugs that are used most often to treat ALL are:
For some subtypes or classifications of ALL, you may get targeted therapies. These therapies are newer cancer treatments that are more exact than standard chemotherapy.
Targeted therapies work in one of three ways:
Therapies called Abelson tyrosine kinase inhibitors (ABL TKIs) are used for Ph+ ALL. They block the leukemia-causing effects of the protein made by the BCR-ABL gene — an abnormal gene in the Philadelphia chromosome.
The targeted drugs used for Ph+ ALL are usually taken daily as pills. They include:
For some people with B-cell ALL, antibody-based treatments may be an option. Antibodies are a different kind of targeted therapy because they are proteins that your immune system normally makes to target a specific protein (called an antigen). Researchers have found ways to take advantage of this by making antibodies that can attack cancer if the leukemia cells have certain antigens. One example is rituximab, which may be added to chemotherapy if your leukemia has a protein called CD20. Another targeted therapy called inotuzumab ozogamicin may be an option. It uses an antibody to deliver an anti-cancer drug to your cancerous B cells.
Immunotherapies are some of the latest innovations in ALL care. They use the power of your immune system to fight your cancer.
For ALL that has come back or didn’t respond to other treatments (relapsed or refractory ALL), your physician may recommend a form of treatment that uses your immune system, such as:
Fred Hutch is one of the first cancer centers in the nation to offer FDA-approved cellular immunotherapy for ALL. Tisagenlecleucel, known as the brand name Kymriah®, and brexucabtagene autoleucel, known as the brand name Tecartus®, are two different CAR T-cell therapies available only at certified treatment centers.
Immunotherapies are some of the latest innovations in ALL care. They use the power of your immune system to fight your cancer.
For ALL, most people who have a transplant get stem cells from a donor. This is called an allogeneic transplant, and it works in two ways:
More people are eligible for allogeneic transplants than ever before, because of advances available at Fred Hutch, including:
Sometimes, physicians transplant the patient’s own stem cells, which were taken out earlier and had the leukemic cells removed (autologous transplant). This doesn’t happen very often with ALL.
While you’re in active treatment, your ALL care team will see you regularly for exams and tests to check:
We update your treatment plan based on the best scientific evidence as well as how your disease responds and what you prefer.
— Christen N. Martino, ARNP, lymphoma survivor
Along with treating your ALL, Fred Hutch provides a range of services to support you and your caregiver before, during and after treatment. This is part of how we take care of you — not just your disease.
From dietitians to our Spiritual Health team, we have experts who specialize in caring for people with cancer. We understand this may be one of the most intense and challenging experiences you and your family ever go through. We are here to provide the care you need.
Learn more about Supportive Care
When your disease is in remission and your active treatment ends, it’s still important to get follow-up care on a regular basis. At follow-up visits, you’ll see the same team who treated your ALL. They will check: