Chemotherapy for ALL

Chemotherapy uses drugs to kill cancer cells. There are 5 main stages of chemotherapy for ALL:

1. Pre-phase steroids

Steroids will start as soon as diagnosis is confirmed and continue until induction begins. This is usually a few days.

2. Induction

Intensive treatment using several chemotherapy drugs, with the aim of clearing all the cancer cells from your blood and bone marrow. The induction stage can last 8 weeks.

You will have a bone marrow biopsy afterwards to see how well the treatment has worked. The aim is for the leukaemia to go into remission.

Remission

Remission is when your bone marrow is producing blood cells normally and you have fewer than 5% of the immature leukaemia cells (blasts) in your bone marrow. Your red blood cell, white blood cell and platelet counts have returned to normal levels, or close to normal levels, and there are no signs or symptoms of the disease.

3. Intensification

Once remission occurs, more courses of chemotherapy are usually given with a different combination of drugs. This is to clear any remaining leukaemia cells and to protect your brain and spinal fluid from leukaemia. An intensification cycle lasts around 4 weeks.

4. Consolidation

Normally, 4 cycles of consolidation are given. The 3rd cycle lasts around 6 weeks. The other cycles are around 4 weeks each.

5. Maintenance

The aim of maintenance is to prevent ALL from recurring (coming back). Maintenance usually involves low doses of chemotherapy and steroids given in 3-monthly cycles. This is far less intensive than the other phases and treatment is given over a longer period of time. You will be treated as an outpatient and will see your doctor or nurse regularly, usually weekly, in hospital. You may be able to go back to work and normal activities during the maintenance stage.

Read more about chemotherapy and its side-effects.