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Acute lymphocytic leukemia

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of leukemia.

Alternative Names

Acute lymphoblastic (or lymphocytic) leukemia

Highlights

Drug Approvals

• Imatinib (Gleevec) is approved for treating Philadelphia chromosome-positive acute lymphocytic leukemia (ALL) that has not responded to treatment, or has returned after treatment.
• Dasatinib (Sprycel) is approved for patients with Philadelphia chromosome-positive ALL who are resistant to imatinib. An important 2006 New England Journal of Medicine study indicated dasatinib’s benefit in treating these patients.
• Pegaspargase (Oncaspar) is approved for treating children and adults with newly diagnosed ALL. This drug was previously approved only for patients who were allergic to L-asparaginase (Elspar). Patients can now receive pegaspargase instead of L-asparaginase as part of a combination chemotherapy regimen. With pegaspargase, patients need only 3 injections during a 20-week treatment, instead of the 21 injections required for L-asparaginase.

Investigational Drugs

Nilotinib (AMN-107), a drug that is similar to dasatinib, has shown promising results in treating patients with Philadelphia chromosome-positive ALL who are resistant to imatinib.

Treatment Research

• The chemotherapy drug 6-mercaptopurine (Purinethol) should remain a standard part of maintenance therapy for children with ALL, recommends a 2006 study in the Lancet . Researchers found that an alternative drug, 6-thioguanine (Tabloid), has risky side effects that outweigh its benefits.
• Allogeneic (donor) stem cell transplantation may be an effective treatment option for patients with Philadelphia chromosome-positive ALL who are resistant to imatinib, suggests a 2006 study in Blood .

Cranial Radiation and Stroke Risk

Children with leukemia who receive cranial (skull) radiation therapy may be at increased risk for stroke decades after their treatment ends, suggests a 2006 study in the Journal of Clinical Oncology . Researchers found that strokes could happen 10 - 20 years after treatment. Stroke occurred on average in 1 in 125 patients with leukemia compared to 1 in 500 healthy patients. Patients who received the highest doses of radiation had the greatest risk of stroke.

• Review Date: 1/16/2007
• Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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