Treatment of Acute Lymphoblastic Leukaemia

As in all leukaemic treatment the first thing in acute lymphoblastic leukaemia is also remission induction. This treatment method is called combination chemotherapy. The following drugs are used in this treatment method.

·         Vincristine

·         A glucocorticoid – dexamethasone, prednisolone

·         An anthracycline - Daunorubicin

·         Asparaginse (crisantaspase)

When the above therapy succeed in achieving complete remission there are some other actions that has to be taken. They are,

·         Consolidation - The second step is consolidation after a successful remission is achieved. The patients will be a number of cytotoxic drugs several times. One such drug is Methotrexate, which is used in high dosage.

·         Allogenic transplantation - In some patients who are at high risk allogenic transplantation is done when they achieve the first remission.

·         Intrathecal Chemotherapy - May have to be continued upto two years depending on the risk. This is under platelet cover and with high doses of systemic Cytosine arabinoside or methtraxate.

·         Cranial irradiation – This now only done for those who are at high risk.

·         Maintanace therapy – Continuation of treatment with methotrexate and mercaptopurine for up to 2 years. A white cell count of 3×10⁹/L is targeted.    


References : Kumar P and Clark M, 2009. Clinical Medicine. 7th ed.