A combination of chemotherapy has been proven to be the best treatment for children with ALL. This can be given by mouth, by injection into the vein or into the cerebrospinal fluid. Chemotherapy may be used in conjunction with radiation therapy if required.
Children with ALL treated in contemporary medical facilities have about 80%-90% chance of cure after treatment. Prompt medical attention and aggressive therapy are important for the best progress.
Is Bone Marrow (or Stem Cell) Transplantation Needed?
Transplantation treatment is generally not required. Bone marrow transplantation will be required for leukaemia cells that carry certain molecular changes, no response to chemotherapy and when the disease comes back during or after treatment.
Why Children with ALL may Receive Different Treatment?
Treatment of ALL is determined by the leukaemia cell type, molecular changes and the initial response to chemotherapy. This is meant to maximise the chance of cure while avoiding an excess of long-term side effects from treatment.
Leukaemia cells are classified at the time of diagnosis into B-cell or T-cell disease. They are also studied to see if they have any chromosomal or molecular changes at the DNA level. The reduction of leukaemia cells both in the blood and in the bone marrow is closely monitored during treatment. These are important to determine the prognosis of a child with ALL.
What are the Side Effects of Treatment?
Most of the side effects of treatment for ALL come from the chemotherapy. Chemotherapy kills leukaemia cells that reproduce rapidly. It also affects fast growing normal cells, including the cells from the hair, guts, mouth and bone marrow.
Nausea, vomiting, presence of mouth ulcers and hair loss are common but temporary. Measures will be taken to minimise the discomfort of nausea,vomiting,and mouth ulcers. Low blood count cells causing anaemia and thrombocytopenia (reduction in platelet count) is almost universal. Transfusion treatment is commonly required to reduce the adverse effects of anaemia and to prevent or control bleeding due to low platelet counts. Advice will be given on precautions against infection due to neutropenia (low white cell count).
Chemotherapy may have long-term side effects such as toxicities to the heart, hormonal functions and later fertility. There is also a small risk of developing a second cancer in later life, especially when radiotherapy has been used.
Will there be any Risk to Other Family Members?
ALL is almost never hereditary in origin and ALL affecting more than one member of the family is extremely rare. Like other cancers, ALL is not contagious and cannot be passed from one individual to another, even with close contact or food sharing. Therefore, parents should not be burdened by the fear that the disease will affect a subsequent sibling.
What a Parent Can Do to Help a Child with ALL?
Parents are the greatest and most important support person to a child with serious illness such as ALL. The medical and nursing team is always available to discuss with the parents about the nature of the illness, the treatment and its side effects, and care of the child after the completion of treatment. We believe that all children with cancer should have the opportunity to recover physically and emotionally. Caring parents play an important role in any successful treatment.
