Acute Lymphocytic Leukemia Treatment and Survival Rate

April 19, 2024 
This page was reviewed under our medical and editorial policy by Guido Marcucci, M.D., Chair, Department of Hematologic Malignancies Translational Science, City of Hope Duarte

Following an acute lymphocytic leukemia diagnosis, the care team will develop a treatment plan that’s customized for the patient and targets their cancer subtype, while also considering other health conditions and personal preferences.

This guide to acute lymphocytic leukemia treatment and survival provides patients and their families with information to help them better understand the disease.

How Is Acute Lymphocytic Leukemia Treated?

Chemotherapy

The main treatment for ALL is chemotherapy, which uses medication to destroy cancer cells. These treatments generally take place in three phases: induction, consolidation and maintenance. 

ALL treatment courses may be lengthy, upwards of several years, so the experience may be both physically and mentally demanding for patients.

Patients may benefit from community or family support, and their health care team may also provide more resources.

Here’s what to expect from each stage of acute lymphocytic leukemia treatment.

Induction

The first phase of chemotherapy is called induction. It aims to put ALL into remission, meaning that blood counts return to normal levels and cancer cells are no longer seen in a bone marrow biopsy.

The first month of treatment may feel intense and require frequent visits to the hospital and supervised care to manage the risk of infection or complications. One or several chemotherapy drugs may be given.

The induction stage may also include additional treatment to prevent the cancer from spreading to the central nervous system (CNS). This is called CNS prophylaxis. It involves direct injection of chemotherapy drugs into the cerebrospinal fluid, and potentially radiation to the spinal cord and brain.

Consolidation

Consolidation, also known as intensification, is the second phase of treatment. The patient is likely to be in remission during this stage, but another short course of chemotherapy may be given to help destroy any remaining cancer cells.

For certain ALL subtypes, or patients who have a higher risk of recurrence, a stem cell transplant may be given in conjunction with chemotherapy and/or radiation therapy. Stem cells may either come from the patient (an autologous transplant) or from a donor (an allogeneic transplant) and restore healthy cells to the body.

Maintenance

In the maintenance phase, the patient receives regular chemotherapy and other medications as needed. This phase may last for about two years.

If the cancer remains after the consolidation phase, additional treatment may be administered, including immunotherapy or participation in clinical trials.

CAR T Cell Therapy

If the patient doesn't respond to chemotherapy or experiences an ALL recurrence, he or she may be a candidate for chimeric antigen receptor (CAR) T cell therapy. CAR T cell therapy is a type of immunotherapy that allows the care team to collect T cells from the patient, alter them, and then reintroduce them to the patient's body to target and destroy cancer cells. 

Acute Lymphocytic Leukemia Survival Rate

Five-year relative survival rates reflect the percentage of patients who may be expected to still be alive at least five years after their initial diagnosis, compared to people without that cancer type. According to the National Cancer Institute, ALL five-year relative survival rates are stratified by age:

• All ages — 72.4%
• People under age 50 — 82.5%

Keep in mind that cancer survival rates are only estimates and based on past data. Each patient’s health is unique, and many factors affect survival rates. Patients are urged to speak with their health care team to learn more about their cancer type and what it means for their health.