Children suffering from acute lymphoblastic leukemia (ALL) should be treated at a center with a specialized pediatric oncologist, even better if the center has an ALL specialist. The most standard regimen of treatment followed for childhood ALL is chemotherapy for two to three years in three phases. The patient should be closely monitored during diagnosis and treatment.
The chemotherapy is conducted in three phases,
The patients are grouped according to risk prior to detailing chemotherapy regimen. Treatment related complications are common during treatment and hence treatment should be carried out in a center where there is adequate hematologic support and experts to handle infections and other complications arising during course of treatment.
Induction: Leukemia treatment begins with induction. The aim of this phase of treatment is remission of disease. During induction, bone marrow samples do not show leukemia cells, and there is new normal marrow cell. Blood count returns to normal. Most children go into remission within one month of starting induction therapy.
Consolidation: This is the most intense period of therapy. All leukemia cells are gotten rid of in this phase. The phase lasts for one or two months. Based on risk, patients are administered chemotherapy drugs. Some pediatric ALL patients are given an option of stem cell therapy during this phase.
Maintenance: if leukemia is in remission through first and second phase, maintenance can begin.
The entire course of treatment would take about 2 to 3 years.
Chemotherapy is prolonged or dosages increased if the leukemia does not go into remission during treatment. Similarly, if leukemia reappears within 6 months of beginning treatment, stem cell transplant using stem cells of a healthy sibling is advised.
In children where leukemia cells are found in cerebrospinal fluid or testicles and not in bone marrow during relapse, radiation therapy is advised.
Clinical trials are available for children with ALL, which use specially designed protocols with low and high risk of treatment failure. Clinical trials compare therapies and incorporate a better treatment approach for improving survival, reducing toxic side effects.
Stay tuned for more on childhood ALL treatment options and protocols.
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