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Acute Lymphoblastic Leukemia (ALL)

You weren’t quite prepared to hear your child’s diagnosis. Blood cancer. Chances are, those words gave you chills.

Learning your child has acute lymphoblastic leukemia (ALL) can be overwhelming. And maybe even terrifying. You might be feeling a dozen different emotions and have a thousand questions about what their care and future will look like. You want to reassure your child that they’ll be OK, but you probably need some reassurance, too. It’s important to know you don’t have to face any of this alone.

At Cleveland Clinic Children’s, our compassionate pediatric cancer providers are here for you and your child, every step of the way. We’ll help you navigate their diagnosis, treatment and recovery — and the difficult emotions that might come with all of it.

Why Choose Cleveland Clinic Children’s for Acute Lymphoblastic Leukemia Care?

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Trusted experts

Our pediatric cancer providers specialize in diagnosing and treating children and teens with blood cancers like ALL. We offer customized treatments for children who have all stages and types of this disease. Meet our team.

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Specialized knowledge

Our team specializes in cellular therapy (CAR T-cell), immunotherapies and bone marrow transplants, as well as other leading-edge therapies for children with advanced ALL, including one not widely available at other hospitals. We also participate in clinical trials for new treatments for acute lymphoblastic leukemia. Talk to your child’s provider to see if your child is eligible.

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Personalized care

Cleveland Clinic Children’s provides personalized support to help you and your child navigate their cancer diagnosis and treatment. Each family works with a nurse care coordinator who helps manage everything about your child’s care and answers any questions.

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Caring approach

Social workers, psychologists, child life specialists, art and music therapists and therapy dogs offer support for your child and family beyond medical care. We also can provide a community of support by connecting you with other families with children going through cancer treatment.

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Virtual visits

We know your child won’t always feel up to leaving the house. Not all visits have to be in person. Our virtual visits give them (and you) the chance to meet one-on-one with providers from home. All you need is an internet connection and a web-enabled device like a smartphone, tablet or computer.

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National recognition

U.S. News & World Report consistently ranks Cleveland Clinic Children's a top hospital in the nation. Newsweek has also named Cleveland Clinic a top hospital in the world.

Diagnosing Acute Lymphoblastic Leukemia in Children and Teens

A team of Cleveland Clinic Children’s healthcare providers are here for you and your child during their experience with acute lymphoblastic leukemia. This care team could include:

During your child’s first visit, their healthcare providers will begin by checking them out with a physical exam and talking with you about their medical history. The providers might also do blood work since ALL involves white blood cells and others tests to get more information.

Bone marrow biopsy

This test lets us look for abnormal blood cells or check for cancer cells in your child’s blood and bone marrow. During a bone marrow biopsy, we’ll first give them general anesthesia so they will be asleep and not feel any pain. 

Your provider will use a special needle to remove liquid from spongy bone marrow in the back of your child’s hip (the most common spot). They’ll also get a small piece of bone marrow to test. A bone marrow biopsy lasts about 30 minutes, and once your child wakes up, they should be able to go home.

Spinal tap (lumbar puncture)

Everyone has clear fluid surrounding their spine and brain called cerebrospinal fluid. Your providers can learn a lot from a sample of it, including what kind of white blood cells are there and if there is any ALL in the spinal fluid. 

During a spinal tap, your child will likely have a sedative delivered intravenously (IV) or general anesthesia. They’ll be relaxed or asleep. Their provider will insert a thin needle between the bones in their spine (vertebrae) to remove spinal fluid for testing. Your child should be able to go home after they wake up.

Genetic testing

Sometimes, acute lymphoblastic leukemia starts from a genetic mutation or other issues. If appropriate, your family can meet with one of our genetic counselors to discuss options for genetic testing and counseling. 

Locations

We offer treatment for Acute Lymphoblastic Leukemia at the following location in Northeast Ohio.

Acute Lymphoblastic Leukemia Treatment at Cleveland Clinic Children’s

Once we confirm an ALL diagnosis, we’ll work with you to craft a personalized treatment plan for your child based on their age, health and other factors. 

Usually, ALL is treated with chemotherapy and consists of a few general phases:

  • Induction: We use chemo to destroy cancer cells in your child’s blood and bone marrow to put them in complete remission (no signs of cancer). 
  • Consolidation: Once your child is in remission, they undergo chemotherapy for several months to make sure we’ve destroyed all cancer cells.
  • Maintenance: In this last phase, your child takes oral chemotherapy medications for up to two years as maintenance. Many children return to school and other activities during this phase. 

It’s important to understand treatment isn’t the same for every child. Most children need multiple rounds of intensive chemotherapy over several months, but some may need chemotherapy for a year or longer. 

When we design your child’s personalized care plan, we’ll use information from diagnostic tests and their physical exam and medical history to decide what drugs and dosage to use and how many rounds of treatment they’ll need in each treatment phase.

Other acute lymphoblastic leukemia treatments

In addition to chemotherapy, we might also recommend using other options, including: 

  • Radiation therapy to their spine and brain, especially if we find potential cancer cells in their spinal fluid. Radiation treatment destroys cancer cells in their spinal fluid that chemotherapy drugs might miss. 
  • Bone marrow transplant is a treatment where your provider replaces unhealthy cells with healthy ones.  
  • Targeted therapy targets specific genetic mutations (changes) that turn healthy cells into cancer cells.
  • Immunotherapy (including CAR T-cell therapy) is a rapidly advancing field in ALL.

During treatment, your child will have regular testing so their providers can see how well they’re responding to chemotherapy. This could include a bone marrow biopsy after the first cycle of chemotherapy and lumbar punctures at regular intervals throughout treatment. 

Relapsed acute lymphoblastic leukemia 

Outcomes for children diagnosed with childhood ALL are good. Overall, the five-year survival rate for acute lymphoblastic leukemia is about 90%. Most children will go into deep remission and live an active, healthy life. 

But, if your child’s ALL relapses, they’ll need additional treatment. We offer options that aren’t available at all hospitals, including: 

Long-Term Care and Support

After cancer treatment, children with ALL need ongoing appointments and testing. They might also need treatment for conditions that could develop later. We provide care over the long haul — even into adulthood — and will help your child live a long, healthy life.

Taking the Next Step

The words, “cancer diagnosis,” can upend the lives of your child and family. But at Cleveland Clinic Children’s, we’ll surround your child with the highest level of care and support they (and your family) need from day one. From innovative treatments and clinical trials to a warm, compassionate care team, we’re here for your child and you throughout their entire cancer journey. 

Getting an appointment with Cleveland Clinic Children’s acute lymphoblastic leukemia experts is easy. We’re here for you.

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Getting an appointment with Cleveland Clinic Children’s acute lymphoblastic leukemia experts is easy. We’re here for you.


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Survivorship

Learning your child has cancer can be stressful, shocking and challenging. From the moment you get the news, your child is a survivor. As you face the challenges that go along with their cancer treatment and recovery — physical and emotional — we’ll be right there with you. At Cleveland Clinic Children’s, survivorship care is one part of your child’s journey. Through our Childhood Cancer Survivorship Program, you’ll find support for any medical and emotional challenges that may happen in the years following cancer treatment.

We’re also there for you throughout this entire journey. We offer a wide range of services, resources, clinics and support groups to help with any physical, emotional, financial and spiritual needs you might have related to your child’s cancer diagnosis. Lending a helping hand along the way, we want your child to not only survive, but thrive on this journey and beyond.

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