Overall, more than 85% of children with acute lymphocytic leukemia (ALL) are cured with initial chemotherapy only. The cure rate – defined as surviving for at least five years without cancer – ranges from about 60% to 95% depending on factors such as the type and extent of disease and the child's age.
About 40% to 50% of children with acute myelogenous leukemia (AML) are cured with standard chemotherapy. The rate is higher, at least 70%, for children who receive a hematopoietic cell, or stem cell, transplant from a brother or sister.
As doctors find better treatments through clinical trials, the outlook for children with leukemia will keep getting better.
Your child's doctor and health care team will suggest a treatment plan based on the type of leukemia your child has, your child's age and other aspects of your child's health.
Most children with leukemia or other types of cancer take part in clinical trials. These research studies give children the chance to get the very latest treatment options being studied – options that are not offered at all treatment centers.
Your child's doctor will talk with you in detail about any new treatment that might be a match for your child. Then you can decide whether you want to try this option.
Phases of Leukemia Treatment
In most cases, children with leukemia go through three phases of treatment:
This is designed to kill cancer cells in the blood and the bone marrow. For most children with ALL, this phase takes about one month. For those with AML, this phase often takes a few months.
This is designed to kill any cancer cells that are left. They may be inactive but could begin growing again and cause the cancer to recur. For both ALL or AML, this phase often lasts several months.
During this phase, treatment goes on to kill any cells that might be left, but is often given at lower doses. Children with ALL go through this phase, often for two to three years. This phase does not apply to AML because research has found it is not helpful.
Acute Lymphocytic Leukemia Treatment
Standard treatment for ALL is chemotherapy with many medicines. Doctors sometimes use radiation to the brain, spinal cord or testicles if the cancer has spread or there is a high risk that it may spread to those places.
Researchers are testing the use of stem cell transplants in children with ALL that is very high risk or comes back. They are also testing new mixes of chemotherapy medicines. Seattle Children's participates in many research studies testing transplants and new medicines.
Acute Myelogenous Leukemia Treatment
Standard treatment for AML is chemotherapy with more than one medicine. Since AML is sometimes hard to treat doctors often suggest a hematopoietic cell, or stem cell, transplant even after other treatment seems to control the disease or if the disease comes back.
Researchers are testing new treatments, and doctors may suggest these treatments if your child's disease comes back after the first round of treatment.
Many children have more than one type of treatment.
Leukemia Treatment Options
Chemotherapy means giving medicines that go throughout your child's body to kill cancer cells.
Children with leukemia can get chemotherapy through a vein, by mouth, as a shot into the spinal fluid or a shot in the leg. These medicines spread around the body through the bloodstream. They can help kill cancer cells that are in the blood and bone marrow as well as those that may have spread to other places.
Most children with ALL get chemotherapy for two and a half to three and a half years. The first six months are quite intense. Children with ALL need frequent clinic visits during this time.
Most children with AML get chemotherapy for six to nine months. They stay in the hospital throughout this time, except that they typically can go home for about one week each month between chemotherapy courses.
A course is a series of chemotherapy sessions. Researchers are testing new mixes of chemotherapy medicines to find the best ones for each type of disease.
Leukemia can spread to other places in the body such as the brain, spinal cord or testicles. If your child has signs of cancer in these places, your child will receive radiation there as well as chemotherapy.
All patients with leukemia get chemotherapy into the spinal fluid. This is to keep the cancer from spreading there or to treat the cancer if it is there.
Our patients receive chemotherapy at our hospital's main campus in Seattle – most often in the hospital but sometimes in a clinic as outpatients.
If your child's cancer has spread or may spread to the brain, spinal cord or testicles, your child's doctors may suggest radiation to that area. Radiation uses high-energy X-rays to kill cancer cells. A machine sends a dose of radiation through the outer structures, such as the skin and the skull, into deeper parts of the body.
Our leukemia patients receive radiation therapy through our partner UW Medicine.
Learn more about Seattle Children's Radiation Therapy Service.
Hematopoietic cell transplant, or stem cell transplant
Sometimes a child's leukemia is under control but is not likely to be cured with normal chemotherapy.
The child may have a hematopoietic cell, or stem cell, transplant. He receives high doses of chemotherapy and sometimes radiation to kill cancer cells that are still in his body. Such high doses damage the bone marrow, so the marrow cannot make new stem cells that would become blood cells.
Doctors then give the child bone marrow or stem cells through a vein. These cells then create new bone marrow.
The cells come from a donor – a family member or a donor who is not related. A transplant using stem cells from another person is called an allogeneic transplant.
For children who have ALL, doctors suggest a transplant for these situations:
- High-risk disease, such as infant cancer
- Some cancer with very high-risk features
- Cancer that comes back
For children with AML, doctors sometimes suggest a transplant when the disease first gets under control, because AML is harder to treat than ALL.
Our patients who have a stem cell transplant receive this care through Children's and our partner Fred Hutchinson Cancer Research Center.
Learn more about the Pediatric Blood and Marrow Transplant Program.
New leukemia treatment options
Researchers are working to find better treatments for childhood leukemia. Through studies, they are testing new combinations of medicines and stem cell transplants for children with ALL. Other studies focus on new AML treatments.
Immunotherapy uses substances either from the body or made in the lab to improve the child's immune system or direct it to fight cancer cells better. In antibody treatment, doctors infuse antibodies made in the lab into the child's body to kill cancer cells or keep them from growing or spreading.
Children's Hospital is well known for leukemia research and is an active member of the Children's Oncology Group (COG). Additionally, we are members of the Therapeutic Advances in Childhood Leukemia (TACL) consortium, a group of pediatric oncology centers that is investigating new approaches to treating leukemia
COG is an international organization of childhood cancer specialists who coordinate research studies to improve survival and cure rates.
We are one of the few childhood leukemia treatment centers that offers Phase I trials - early studies to test new medicines. You can find more details about new treatments under study at the National Childhood Cancer Foundation.
Read more about research at Children's and about follow-up after treatment ends .
You may also want to use these leukemia resources.