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How We Treat Leukemia in Children

  • Children and teens with leukemia are treated at Dana-Farber/Boston Children's through our Childhood Hematologic Malignancy Center. Dana-Farber/Boston Children's has played a key role in refining treatment for childhood leukemia, and we continue to be a world leader in leukemia clinical trials designed to increase cure rates, decrease treatment-related side effects, and improve care for long-term survivors.

    The specific leukemia treatment for your child will be determined by your child's physician based on:

    • Your child's age, overall health, and medical history
    • The extent of the disease and specific sub-type of leukemia
    • Your child's tolerance for certain medications, procedures, or therapies
    • Expectations for the course of the disease
    • Your opinion or preference

    Leukemia treatment usually begins by addressing the presenting symptoms such as anemia, bleeding, and/or infection. In addition, leukemia treatment may include (alone or in combination):

    • Chemotherapy/intrathecal medications — medications are inserted through a needle into the spinal cord into the area called the subarachnoid space
    • Radiation therapy — is sometimes used, although never used as part of induction therapy
    • Bone marrow/stem cell transplant — stem cell transplant is almost never used to treat ALL, except for certain rare subtypes or if the leukemia comes back (relapses) after initial treatment with chemotherapy
    • Biological therapy — only rarely used for the treatment of ALL
    • Medications – to prevent or treat damage to other systems of the body caused by leukemia treatment, and for nausea and side effects of treatment
    • Blood transfusions — for red blood cells, platelets
    • Antibiotics — to prevent/treat infections
    • Continuous follow-up care — to determine response to treatment, detect recurrent disease, and manage late effects of treatment

    Stages of Leukemia Treatment

    There are various stages in leukemia treatment, including:

    • Induction — a combination of chemotherapy and medications given to stop the process of leukemia cell replication in the bone marrow. Remission occurs when the leukemia cells are no longer visible under the microscope in either the bone marrow or blood. However, even when remission is achieved, leukemia is still present in the body, which is why further treatment is necessary. The induction phase may last approximately one month and can be repeated if remission is not achieved.
    • Intensification or consolidation — continued treatment with chemotherapy to eliminate leukemia cells that are still present in the body. Therapy in this phase may include chemotherapy given to the central nervous system to prevent the spread of leukemia cells to the spinal cord or brain. Radiation therapy may also be given to the brain during this phase.
    • Maintenance or continuation — the goal of this phase is to eradicate all leukemia from the body. Usually, less intensive chemotherapy is used, much of which can be given at home. This phase can last from months to several years. Regular visits to your child's physician are required to determine response to treatment, detect any recurrent disease, and manage any side effects of the treatment.

    Leukemia Clinical Trials

    Dana-Farber/Boston Children's is actively engaged in leukemia clinical trials, leading to new therapies and aiming for eventual cures. Our clinical team works closely with leukemia researchers to quickly develop new treatments based on the latest scientific discoveries.

    Clinical trials at Dana-Farber/Boston Children's are designed to investigate new therapies for refractory or relapsed leukemia, novel combinations of chemotherapy drugs, and promising new treatment agents. Our researchers are conducting randomized clinical studies to reduce treatment intensity, to lessen side effects, and to test more intense and newer therapies to improve cure rates. In addition, our researchers have joined forces with scientists at the Broad Institute of Harvard and MIT to identify a previously unrecognized AML target that responds well to drugs that destroy cancer cells and may be an excellent candidate for use in clinical trials.

    Learn more about clinical trials for pediatric cancer.

    Long-term Outlook for Children with Leukemia

    The prognosis for children diagnosed with leukemia greatly depends on:

    • The extent of the disease
    • Disease response to treatment
    • Genetic abnormalities of the leukemia
    • Age and overall health of your child
    • Your child's tolerance of specific medications, procedures, or therapies
    • New developments in treatment

    As with any cancer, prognosis and long-term survival can vary greatly from child to child. Prompt medical attention and aggressive therapy are important for the best long-term outlook.

    Cancer Survivorship for Children with Leukemia

    Continuous follow-up care is essential for any child diagnosed with leukemia. Side effects of radiation and chemotherapy, as well as secondary cancers may occur in survivors of leukemia. New methods are continually being discovered to improve treatment and to decrease side effects of the treatment for the disease.

    Survivorship care is important for patients with leukemia in remission. Our pediatric cancer survivorship programs, which set the national standard for childhood cancer survivorship care, offer ongoing care to manage late effects caused by your child's cancer or the treatment received.