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Acute Lymphoblastic Leukemia (ALL) Treatment

Also called: acute lymphocytic leukemia, acute lymphoid leukemia, ALL

Acute lymphoblastic leukemia (ALL) is a cancer of the blood and bone marrow. Bone marrow is a soft, sponge-like tissue in the center of many bones. It makes blood cells.

The bone marrow makes 3 types of blood cells:

  • Red blood cells: They carry oxygen.
  • White blood cells: They fight infection.
  • Platelets: They help blood to clot.

In ALL, the bone marrow makes too many white blood cells (lymphocytes) that do not work correctly.  There is no room for healthy cells to develop. As a result, children and teens cannot fight infections well. They can get very sick. ALL is the most common form of childhood leukemia and the most common form of childhood cancer overall. About 3 in 4 children and teens with leukemia have ALL. Doctors often do not know why leukemia happens. It is not because of anything the child or family did.

Learn more about acute lymphoblastic leukemia on the Together by St. Jude™ online resource.

Treatment of acute lymphoblastic leukemia 

Chemotherapy is the main treatment for ALL. It has 3 phases and can take 2–2.5 years to complete.

The treatment plan depends on the chance that the leukemia may not respond to treatment or may come back after treatment has finished. This is called risk-based treatment.

St. Jude groups ALL cases as low risk, standard risk, and high risk. Cases that are most likely to respond to treatment are low risk. Leukemia that is the hardest to treat is high risk.

Children with low-risk ALL get less medicine than children with standard-risk ALL. Children with high-risk ALL get more medicine than children with standard-risk ALL. They may need more treatments such as immunotherapy or stem cell (bone marrow) transplant.

For specific types of ALL, children may get targeted therapy or immunotherapy. These therapies help the body identify and kill certain types of cancer cells.

Your child’s oncologist will discuss treatment options with you.

Acute lymphoblastic leukemia clinical trials 

St. Jude offers clinical trials and cancer research studies for children, teens, and young adults for ALL. Learn more about clinical research at St. Jude.

CATCHAML: CAR T-Cell Therapy for Acute Myelogenous Leukemia (AML)

Study goal:

The main purpose of this study is to find the highest dose of CD123-CAR T cells that is safe to give patients with AML.  We also want to study the side effects of the treatment and learn how effective it is in fighting this type of cancer.


21 years old or younger

INOMRD: Inotuzumab Ozogamicin for High-Risk B-Cell Acute Lymphoblastic Leukemia

Study goal:

The main goal of this study is to learn about the good and bad side effects of inotuzumab ozogamicin in children with this type of leukemia and to find out how well the drug works to get rid of the disease.


Younger than 22 years old

REF2HCT: Haploidentical Bone Marrow Transplant for Relapsed or Refractory Leukemia, Lymphoma, or Myelodysplastic Syndrome After an Earlier Transplant

Study goal:

The main goal of this study is to learn about the good and bad effects of transplanting blood cells donated by a family member to children and young adults with cancer that has come back or did not improve after a previous bone marrow transplant.


21 years old and younger

MEMCAR19: Allogeneic CAR T-Cell Therapy for Relapsed/Refractory CD19-Positive Leukemia

Study goal:

The main goal of this study is to learn the largest dose of memory CAR T cells that can be safely given. Researchers also want to learn about the way memory CAR T cells act in the body and how effectively they treat this type of cancer.


Donor: At least 19 years old; Recipient: 21 years or younger

PAINBDY1: Treating Pain in Children with Cancer: Pain Buddy

Study goal:

The main goal of this research study is to help us learn how to better treat pain and symptoms in children going through chemotherapy cancer treatment.


8 to 18 years old

TRIALS: Transfusional Iron Overload Among Leukemia Survivors

Study goal:

1) To find out how many long-term survivors of leukemia have iron overload by using MRI testing. 2) To study how the number of red blood cell transfusions you received determines whether you have iron overload. 3) To explore how your age at the time of cancer therapy, the length of time from therapy, and gender affects whether you develop iron overload. 4) To find out if iron overload is causing problems with your organs.

DIRECT70: CAR T–Cell Therapy for Children with Blood Malignancies

Study goal:

The purpose of this study is to find the highest dose of CD70+ CAR cells that is safe to give to patients with CD70+ blood cancers.


Up to 21 years old

Acute lymphoblastic leukemia care at St. Jude

  • St. Jude has led the way in how the world treats childhood leukemia since the hospital opened in 1962.
  • St. Jude patients with ALL have a 94% survival rate.
  • St. Jude investigators showed that radiation can be safely omitted from the treatment of most patients with ALL.
  • St. Jude researchers found that there are more than 30 subtypes of ALL. They are based on changes in genes and chromosomes in the leukemia cells. This finding has transformed treatment for ALL. Treatment plans are now based on a child’s subtype and how it responds to specific treatments. The discovery was made possible by the St. Jude Children’s Research Hospital-Washington University Pediatric Cancer Genome Project.
  • At St. Jude, children with ALL can take part in clinical trials if they choose. These studies use the most advanced treatments available. Our goal is to improve each child’s chance of cure and to reduce the side effects of treatment.
  • Our clinical trials are based on years of experience and success. We have helped set the standard for ALL treatment, advancing cure rates, and improving the understanding of the disease. 
  • Our team includes doctors trying to cure the disease and experts in nutrition, rehabilitation, nursing, education, psychology, social work, and child life. This team supports each child through diagnosis, treatment, and recovery. 
A statue of children running and holding hands

Seeking treatment at St. Jude

Patients accepted to St. Jude must have a disease we treat and must be referred by a physician or other qualified medical professional. We accept most patients based on their ability to enroll in an open clinical trial.

How to seek treatment

Contact the Physician / Patient Referral Office

Call: 1-888-226-4343 (toll-free) or 901-595-4055 (local)  | Fax: 901-595-4011 | Email: | 24-hour pager: 1-800-349-4334


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