High-Risk Leukemia Program

From first visit to follow-up, our experts in high-risk leukemia diagnosis, care and research will work as a team to give your child seamless care. The close collaboration between high-risk leukemia experts across various specialties – including bone marrow transplant and immunotherapy clinical trials – sets us apart from other pediatric hospitals.

We leave no stone unturned to find the best possible treatment options specific to your child. Our team is experienced in delivering therapies designed to improve survival and quality of life for children with the toughest cases of leukemia. The program is part of Seattle Children’s Cancer and Blood Disorders Center.

"It was scary hearing the cancer had returned especially since at first, we didn’t think we had any options. It was really encouraging to know there was another option out there and this wasn’t the end of the line.” – Melissa Goldsmith, mom of Fuller, who took part in a T-cell research study after his ALL relapsed.

• Advanced diagnostics and personalized medicine
  • In addition to standard diagnostics, our team uses state-of-the-art tests like molecular profiling and next-generation sequencing (NGS). We examine your child’s cancer cells for certain proteins that can serve as targets for treatment and starting points for the design of new drugs.
  • These tests help us find what is different about your child’s leukemia and identify the best treatment options for them. Whenever possible, we use results from NGS to match your child with therapies that target their specific cancer. This approach is called precision (or personalized) medicine. These therapies could be medicines already approved for another disease or clinical trials of new treatments.
  • We watch your child closely during treatment, using advanced tests to track how they are doing. This lets us know sooner if a different approach is needed.
  • In addition to targeted therapies, we offer advanced treatment options such as new chemotherapies, immunotherapies, radiation therapy and bone marrow transplants.
• Seamless care from world-class experts

  Our entire focus is on helping your child beat their disease and thrive. Our multidisciplinary team of top experts coordinates all aspects of your child’s diagnosis and care.

  • To create a custom treatment plan for your child, our whole team will talk in detail about your child’s case. This includes their diagnosis, treatment and relevant research studies.
  • We will explain our recommended treatment plan to you and to your referring doctor. Between visits to the High-Risk Leukemia Program, the plan guides your child’s care at Seattle Children’s. If you choose to get care at another hospital, your child’s referring doctor can use the plan.
  • Your child will have comprehensive visits with the High-Risk Leukemia team at key milestones. These include their first visit to Seattle Children’s, before-transplant visit, 100 days after-transplant and 1-year follow-up.
  • At each visit, your child will see a childhood cancer doctor (pediatric oncologist), transplant doctor, advanced practice provider (APP), nurse coordinator, pharmacist, social worker and child life specialist.
  • As needed, your child also will see experts in infectious disease, cardio-oncology, nutrition, pain management, radiation oncology and palliative care.
  • Your nurse coordinator will manage your child’s individualized care all through their treatment, starting from first visit. Your nurse coordinator is your single point of contact who will communicate among all members of your child’s team – including you.
  • At Seattle Children's, we work with children and families from around the Northwest and beyond. Whether you live nearby or far away, we can help with financial counseling, schooling, housing, transportation, interpreter services and spiritual care. Read about our services for patients and families.
• Pioneers in bone marrow transplants and improved outcomes

  For most children, treatment for high-risk leukemia includes very high doses of chemotherapy medicines and a bone marrow transplant to replace the body's system for making blood cells and introduce a new immune system. This reduces the risk of leukemia relapse. We work closely with Fred Hutchinson Cancer Center, whose doctors pioneered this lifesaving procedure. 

  Your child’s cancer doctor and transplant doctor work together to plan and monitor treatment. Our team works with your family through the whole process: preparing for transplant, doing the transplant here at Seattle Children’s and caring for your child as they recover.

• Research to improve care and cure rates
  • We are key players in the Pediatric Acute Leukemia (PedAL) Initiative that aims to transform treatment by targeting the specific genetic changes that drive different forms of leukemia.
  • Our physician-scientists do groundbreaking lab research to understand the biology of leukemia and how to fight it.

  As leaders in cancer research, we can offer the very latest treatments being studied. These include phase 1 clinical trials, which many centers do not offer. Early studies are especially relevant for children with high-risk leukemia.

  At Seattle Children’s these include:

  • T-cell immunotherapies such as PLAT CAR T-cell 
  • New drugs that fight cancer with fewer side effects, like Dr. Kasey Leger’s work on treatments that limit damage to the heart.
  • Better approaches to bone marrow transplant to increase effectiveness and reduce side effects.