Acute Lymphoblastic Leukemia (ALL): Treatment Planning
Following a diagnosis of acute lymphoblastic leukemia, we work carefully to determine the best treatment options personalized to your needs. We try to maximize treatment success while balancing the impact that diagnosis and treatment can have on your life.
Your treatment for ALL depends on the phase it has reached, whether it has spread, and if you have had cancer before. It also depends on:
- Your age, overall health, and medical history
- The type and subtype of ALL
- Extent of the disease
- Your tolerance for specific drugs, procedures, or therapies
- Expectations for the course of the disease
- Your preferences
Treatment may differ if the ALL has returned after being treated before. Treatment also depends on what type of ALL you may have.
WHAT TO KNOW ABOUT TREATMENT PLANNING
1Getting Started In Your Care
2Getting Your Diagnosis
3Planning Your Treatment
Considering Your Options »
4Undergoing Treatment & Follow-Up
Select your type of treatment below.
Assessment
Evaluating Options
Choosing Treatment
The team evaluates different options for your treatment plan, based on the details of your diagnosis, including:
- Phase of the leukemia
Learn more about acute lymphoblastic leukemia » - Your age and overall health
- Whether you have had cancer before
We discuss different types of treatment and how to combine them in a sequence that will best treat the cancer.
a. Your doctors may prescribe a treatment plan that combines treatments. The combination of treatments may take place in a certain order to best treat your condition.
You may be able to choose between therapies, depending on your diagnosis.
Your care team will explain the options and the possible treatment sequence. Your doctors will help you make an informed decision about which options may be right for you. An oncologist leads your team and remains your main doctor throughout treatment.
The best treatment for one person might not be the best treatment for another. There are three topics to consider when discussing with your doctor what works best for you.
Medical goals
Your care team will recommend treatment options based on your specific diagnosis. Different types of treatment for leukemia have different goals, such as:
- Slowing or stopping the growth of cancer
- Destroying cancer cells
- Delaying or preventing cancer from coming back (recurrence)
- Managing symptoms of incurable cancer
Personal treatment goals
As you and your care team discuss and make decisions about your treatment plan, it helps to think about your goals for treatment. These goals are different for each person, but health and quality of life are likely at the top of your list. Within those two priorities, there are several questions to consider:
- What’s important to me?
- What do I value?
- What do I need from my relationships?
- What do I want from the treatment experience?
It’s important for your loved ones to understand your treatment goals and wishes, so talk to them. You can ask family and friends for emotional support and help with a variety of issues during your care journey.
The effect of treatment on everyday life
Your care team can help you understand how various treatments can help you achieve your goals. Discuss what you want to be able to do, both during treatment and after it is complete. Issues specific to your health include:
- Treatment: How cancer and treatments will affect you and your ability to continue your everyday activities at work and home
- Side effects and symptoms: How to manage and cope with disease symptoms and treatment side effects
- Balance: Ways to balance aggressive treatment that prolongs survival with side effect management that maintains a good quality of life
Other important issues to consider include:
- Communication: Ways to talk to your family, friends, and others (such as co-workers) about your diagnosis, and how to ask for help
- Emotional well-being: How to manage your own emotions and the emotional impact of your diagnosis on your family and friends
- Relationships: How to maintain relationships with your partner, family, and friends, including intimacy, everyday activities, and responsibilities
- Appearance and body image: Ways to cope with changes that may result from treatment and the cancer itself
- Daily activities: How to take care of yourself, look after your family, and balance work responsibilities while undergoing leukemia treatment
- Travel and distance: How to manage family and work responsibilities if you are coming to Stanford from outside the Bay Area
The team evaluates different options for your treatment plan, based on the details of your diagnosis, including:
- Phase of the leukemia
Learn more about acute lymphoblastic leukemia » - Your age and overall health
- Whether you have had cancer before
close Assessment
We discuss different types of treatment and how to combine them in a sequence that will best treat the cancer.
a. Your doctors may prescribe a treatment plan that combines treatments. The combination of treatments may take place in a certain order to best treat your condition.
close Evaluating Options
You may be able to choose between therapies, depending on your diagnosis.
Your care team will explain the options and the possible treatment sequence. Your doctors will help you make an informed decision about which options may be right for you. An oncologist leads your team and remains your main doctor throughout treatment.
The best treatment for one person might not be the best treatment for another. There are three topics to consider when discussing with your doctor what works best for you.
Medical goals
Your care team will recommend treatment options based on your specific diagnosis. Different types of treatment for leukemia have different goals, such as:
- Slowing or stopping the growth of cancer
- Destroying cancer cells
- Delaying or preventing cancer from coming back (recurrence)
- Managing symptoms of incurable cancer
Personal treatment goals
As you and your care team discuss and make decisions about your treatment plan, it helps to think about your goals for treatment. These goals are different for each person, but health and quality of life are likely at the top of your list. Within those two priorities, there are several questions to consider:
- What’s important to me?
- What do I value?
- What do I need from my relationships?
- What do I want from the treatment experience?
It’s important for your loved ones to understand your treatment goals and wishes, so talk to them. You can ask family and friends for emotional support and help with a variety of issues during your care journey.
The effect of treatment on everyday life
Your care team can help you understand how various treatments can help you achieve your goals. Discuss what you want to be able to do, both during treatment and after it is complete. Issues specific to your health include:
- Treatment: How cancer and treatments will affect you and your ability to continue your everyday activities at work and home
- Side effects and symptoms: How to manage and cope with disease symptoms and treatment side effects
- Balance: Ways to balance aggressive treatment that prolongs survival with side effect management that maintains a good quality of life
Other important issues to consider include:
- Communication: Ways to talk to your family, friends, and others (such as co-workers) about your diagnosis, and how to ask for help
- Emotional well-being: How to manage your own emotions and the emotional impact of your diagnosis on your family and friends
- Relationships: How to maintain relationships with your partner, family, and friends, including intimacy, everyday activities, and responsibilities
- Appearance and body image: Ways to cope with changes that may result from treatment and the cancer itself
- Daily activities: How to take care of yourself, look after your family, and balance work responsibilities while undergoing leukemia treatment
- Travel and distance: How to manage family and work responsibilities if you are coming to Stanford from outside the Bay Area
close Choosing Treatment
Every cancer is different, even in the early stages. The best treatment for one person might not be the best treatment for another. Your doctor will help you make an informed decision about which options may be right for you.
Your doctor will recommend specific treatment for ALL based on:
- Your age, overall health, and medical history
- Extent of the disease
- Your tolerance for specific drugs, procedures, or therapies
- Expectations for the course of the disease
- Your preference
Your treatment plan may consist of one or any combination of the following:
Drug Therapy
Drug therapy, also called systemic or medical therapy, is treatment that works throughout the body to fight leukemia. These drugs slow the growth of cancer cells or destroy them. You can receive drug therapy:
- By mouth (orally) as a pill
- Through the blood vessels (intravenously, or IV) as an injection or infusion
Types of drug therapy for acute lymphoblastic leukemia
At Stanford, our medical oncologists use several types of drug therapy, including:
Chemotherapy: This group of medications stops the growth of rapidly dividing cells in the body, both cancerous and noncancerous. While powerful, chemotherapy can cause more side effects than other medication types, because it cannot distinguish between cancerous and healthy cells. Chemotherapy is a treatment option for almost anyone with cancer.
Chemotherapy Resources
Chemotherapy is a treatment option for most leukemias. We are here to help you prepare and guide you through the process.
Targeted therapy
These medications slow the growth and spread of cancer by cancer by stimulating the immune system or interfering with specific parts of cancerous cells.
For treatment to work, the cancer must have the specific markers a particular medication was designed to target. Some leukemia cells have certain proteins on the cells that promote growth. These proteins cause cancer to grow quickly and spread. Our pathologists look for the presence of these proteins by examining samples of tissue taken during a biopsy.
Targeted Therapy Resources
Should targeted therapy be part of your care plan, we are here to help you prepare and guide you through the process.
Drug therapy scheduling
If your treatment plan involves drug therapy, you will have routine visits to have lab work done, see your doctor, and receive medication. You may need to come in once or twice per week. If you need an infusion, you will visit one of Stanford’s infusion treatment centers, where a nurse specializing in Leukemia care will provide your treatment.
Drug therapy side effects
Side effects from drug therapies vary depending on the type of medication you receive. For example, chemotherapy may affect your hair and nails, because it slows their growth as it slows the growth of cancer cells. Fatigue is also possible. Ask your care team – we can help you manage or prevent many symptoms and side effects that can affect your everyday life.
Blood and Marrow Transplant
A blood and marrow transplant (BMT) is a procedure to replace blood-forming cells (stem cells) that are damaged by certain diseases. The infusion of the stem cells follows treatment with chemotherapy and sometimes radiation therapy. It replaces the blood cells destroyed by the cancer treatment.
BMT may be recommended if the disease:
- Didn’t improve or respond to the drug therapy
- Returned after completing drug therapy (this is called recurrence)
Blood and Marrow Transplant Resources
Should blood and marrow transplant be part of your care plan, we are here to help you prepare and guide you through the process.
What to expect during blood and marrow transplant and how to prepare »
Your health care team for leukemia brings together a multispecialty team of experts dedicated to treating leukemia, blood cancer, and rare forms of blood disorders.
Your doctors
Hematologist
A hematologist provides diagnosis and treatment for adults with blood cancers such as leukemia or myeloma.
View All {0} HematologistsOncologist (MD)
An oncologist is a cancer doctor who provides diagnosis and treatment for cancer. Some oncologists specialize in particular cancer treatments like drug therapy, surgery or radiation therapy.
Working closely with your oncologist and hematologist, your pathologist performs and reads laboratory tests to determine the type and stage of cancer present. These doctors have special training to detect and diagnose cancer. They use a microscope to examine tissue samples taken during a biopsy. As with radiologists, you may not meet your pathologist.
Blood And Marrow Transplant Specialist
A blood and marrow specialist doctor is trained in therapy to transfer healthy bone marrow cells into a patient after their own unhealthy bone marrow has been eliminated.
View All {0} Blood And Marrow Transplant Specialists
Extended care team
This health care provider works with your cancer doctors to help with diagnosis and treatment. An advanced practice provider can be a nurse practitioner, physician’s assistant, or clinical nurse specialist.
Multidisciplinary care coordinators are specialized registered nurses who provide one-on-one support to guide you through the cancer treatment process. These coordinators serve as your point of contact to help manage your care, from your first appointment through follow-up visits. They assess your needs, answer your questions, make referrals, coordinate appointments, and provide patient education.
The administrative assistants help with administrative issues such as scheduling your appointments, managing your paperwork, and requesting your medical records.
This team member helps you during your doctor visits by:
- Bringing you to your exam room after you check in for an appointment
- Providing you with a hospital gown or other clothing for your physical exam
- Taking your vital signs before your doctor sees you
A staff member calls you before your first appointment to:
- Provide information that you need to know to prepare
- Provide a list of what you need to bring
- Help gather your medical records
Support services
PathWell is your connection to personalized support services before, during, and after your treatment. Our teams of doctors, nurses, social workers, spiritual care providers, nutrition experts, financial counselors, and more work with your cancer care team to provide comprehensive specialized care to you and to your family.
PathWell can also connect you to the Stanford Cancer Supportive Care Program, which provides free classes, workshops, fitness classes, services, and support to all cancer patients. The program offers a leukemia and lymphoma support group designed to provide mutual support and education to members who could benefit from meeting with others whose situations are similar to their own. Caregivers, family, and friends are welcome.
- 650-498-6000 Ask for the PathWell team
Stanford Health Library
For confidential help with your health care questions, contact the Stanford Health Library. Professional medical librarians and trained volunteers can help you access journals, books, e-books, databases, and videos to learn more about medical conditions, treatment options, and related issues.
- 875 Blake Wilbur, Palo Alto: 1st floor near the cafe, 650-736-1960
- South Bay Cancer Center: 3rd floor lobby, 408-353-0197
- Email us your questions: healthlibrary@stanfordhealthcare.org