A nurse is creating a plan of care for a child who has acute lymphoid leukemia

What are the symptoms of acute lymphoblastic leukemia?

Symptoms of ALL include:

• Frequent infections
• Fever
• Easy bruising
• Bleeding that is hard to stop
• Flat, dark-red skin spots (petechiae) due to bleeding under the skin
• Pain in the bones or joints
• Lumps in the neck, underarm, stomach or groin
• Pain or fullness below the ribs
• Weakness, fatigue
• Paleness
• Loss of appetite
• Shortness of breath

How is acute lymphoblastic leukemia treated?

Expect your child’s ALL treatment to include three phases:

• Induction — to kill the leukemia cells in the blood and bone marrow and put the disease into remission (a return to normal blood cell counts)
• Consolidation/intensification — to rid the body of any remaining cells that could begin to grow and cause the leukemia to return (relapse)
• Maintenance — to destroy any cancer cells that might have survived the first two phases

Four types of treatment may be used during any of these treatment phases:

• Chemotherapy (“chemo”) — uses powerful medicines to kill cancer cells or stop them from growing (dividing) and making more cancer cells.
  • Chemo may be injected into the bloodstream, so that it can travel throughout the body.
  • Some chemo may be given by mouth.
  • Combination therapy uses more than one type of chemo at a time.
• Stem cell transplant — includes replacing blood-forming cells in the bone marrow that have been killed by chemo and/or radiation therapy:
  • A stem cell transplant gives the patient new blood cells from a donor’s blood or bone marrow. These cells grow into healthy blood cells to replace the ones the patient lost.
  • Some types of stem cell transplants may be called “bone marrow transplants” because the cells come from the donor’s bone marrow.
• Radiation therapy — uses high-energy X-rays or other types of radiation to kill cancer cells or stop them from growing.
• Targeted therapy — uses medicines or other treatments that target and attack specific cancer cells without harming normal cells.

What are the survival rates for acute lymphoblastic leukemia?

• About 98% of children with ALL go into remission within weeks after starting treatment.
• About 90% of those children can be cured. Patients are considered cured after 10 years in remission.

Why choose St. Jude for your child’s ALL treatment?

• St. Jude is the only National Cancer Institute-designated Comprehensive Cancer Center devoted solely to children.
• St. Jude has created more clinical trials for cancer than any other children’s hospital in the United States.
• The nurse-to-patient ratio at St. Jude is unmatched—averaging 1:3 in hematology and oncology, and 1:1 in the Intensive Care Unit.
• The hospital’s leukemia studies have pioneered the way the world treats childhood leukemia.
• St. Jude patients with ALL have a 94% survival rate.
• St. Jude was the first hospital in the U.S. to remove cranial irradiation from treatment for ALL (and, later, for acute myeloid leukemia and non-Hodgkin lymphoma) without harming survival rates.
• St. Jude researchers found unexpected genetic changes in a deadly type of childhood leukemia called ETP-ALL that could change diagnosis and treatment for children with this disease. The finding was made possible by the St. Jude Children’s Research Hospital-Washington University Pediatric Cancer Genome Project. This project is uncovering the genetic basis for some of the deadliest childhood cancers.
• St. Jude pioneered outpatient clinical trials for children with leukemia, reducing the need for inpatient stays.

Find more information on Together.stjude.org about acute lymphoblastic leukemia diagnosis and treatment.