• Highlights
• Introduction
• Symptoms
• Causes
• Risk Factors
• Complications
• Diagnosis
• Prognosis
• Treatment
• Home Management
• Treatment to Achieve Remission
• Treatment During Remission
• Treatment After Relapse
• Resources
• References

Acute lymphocytic leukemia

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of leukemia.

Alternative Names

Acute lymphoblastic (or lymphocytic) leukemia

Highlights

Drug Approvals

• Imatinib (Gleevec) is approved for treating Philadelphia chromosome-positive acute lymphocytic leukemia (ALL) that has not responded to treatment, or has returned after treatment.
• Dasatinib (Sprycel) is approved for patients with Philadelphia chromosome-positive ALL who are resistant to imatinib. An important 2006 New England Journal of Medicine study indicated dasatinib’s benefit in treating these patients.
• Pegaspargase (Oncaspar) is approved for treating children and adults with newly diagnosed ALL. This drug was previously approved only for patients who were allergic to L-asparaginase (Elspar). Patients can now receive pegaspargase instead of L-asparaginase as part of a combination chemotherapy regimen. With pegaspargase, patients need only 3 injections during a 20-week treatment, instead of the 21 injections required for L-asparaginase.

Investigational Drugs

Nilotinib (AMN-107), a drug that is similar to dasatinib, has shown promising results in treating patients with Philadelphia chromosome-positive ALL who are resistant to imatinib.

Treatment Research

• The chemotherapy drug 6-mercaptopurine (Purinethol) should remain a standard part of maintenance therapy for children with ALL, recommends a 2006 study in the Lancet . Researchers found that an alternative drug, 6-thioguanine (Tabloid), has risky side effects that outweigh its benefits.
• Allogeneic (donor) stem cell transplantation may be an effective treatment option for patients with Philadelphia chromosome-positive ALL who are resistant to imatinib, suggests a 2006 study in Blood .

Cranial Radiation and Stroke Risk

Children with leukemia who receive cranial (skull) radiation therapy may be at increased risk for stroke decades after their treatment ends, suggests a 2006 study in the Journal of Clinical Oncology . Researchers found that strokes could happen 10 - 20 years after treatment. Stroke occurred on average in 1 in 125 patients with leukemia compared to 1 in 500 healthy patients. Patients who received the highest doses of radiation had the greatest risk of stroke.

• Review Date: 1/16/2007
• Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial process . A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-2007 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.