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Acute Lymphocytic Leukemia (ALL)
Acute Lymphocytic Leukemia (ALL)

Proper management of acute lymphocytic leukemia (ALL) focuses on control of bone marrow and systemic (whole-body) disease as well as prevention of cancer at other sites, particularly the central nervous system (CNS). Please review our Leukemia Symptoms and Types of Leukemia section for less technical leukemia information. In general, ALL treatment is divided into several phases:

  • - Induction chemotherapy
  • - Consolidation therapy
  • - CNS prophylaxis
  • - Maintenance treatments
  • - Follow-up therapy

Induction chemotherapy to bring about remission - that is, leukemic cells are no longer found in bone marrow samples. For adult ALL, standard induction plans include prednisone, vincristine, and an anthracycline drug; other drug plans may include L-asparaginase or cyclophosphamide. For children with low-risk ALL, standard therapy usually consists of three drugs (prednisone, L-asparaginase, and vincristine) for the first month of treatment. High-risk children may receive these drugs plus an anthracycline such as daunorubicin.

Consolidation therapy (1-3 months in adults; 4-8 months in children) to eliminate any leukemia cells that are still "hiding" within the body. A combination of chemotherapeutic drugs is used to keep the remaining leukemia cells from developing resistance. Patients with low to average-risk ALL receive therapy with antimetabolite drugs such as methotrexate and 6-mercaptopurine (6-MP). High-risk patients receive higher drug doses plus treatment with extra chemotherapeutic agents.

CNS prophylaxis (preventive therapy) to stop the cancer from spreading to the brain and nervous system. Standard prophylaxis may consist of (1) cranial (head) irradiation plus spinal tap or intrathecal (IT; into the space around the spinal cord and brain) delivery of the drug methotrexate; (2) high-dose systemic and IT methotrexate, without cranial irradiation; or (3) IT chemotherapy. Only children with T-cell leukemia, a high white blood cell count, or leukemia cells in the cerebrospinal fluid (CSF) need to receive cranial irradiation as well as IT therapy.

Maintenance treatments with chemotherapeutic drugs (e.g., prednisone + vincristine + cyclophosphamide + doxorubicin; methotrexate + 6-MP) to prevent disease recurrence once remission has been achieved. Maintenance therapy usually involves drug doses that are lower than those administered during the induction phase. In children, an intensive 6-month treatment program is needed after induction, followed by 2 years of maintenance chemotherapy.

Follow-up therapy for ALL patients usually consists of:

  • supportive care, such as intravenous nutrition and treatment with oral antibiotics (e.g., ofloxacin, rifampin), especially in patients with prolonged granulocytopenia; that is, too few mature granulocytes (neutrophils), the bacteria-destroying white blood cells that contain small particles, or granules (< 100 granulocytes per cubic millimeter for 2 weeks)
  • transfusions with red blood cells and platelets

A laboratory test known as polymerase chain reaction (PCR) is advisable for ALL patients, since it may help to identify specific genetic abnormalities. Such abnormalities have a large impact upon prognosis and, consequently, treatment plans. PCR testing is especially important for patients whose disease is B-cell in type. B-cell ALL usually is not cured by standard ALL therapy. Instead, higher response rates are achieved with the aggressive, cyclophosphamide-based regimens that are used for non-Hodgkin's lymphoma.

Among ALL patients, 3-5% children and 25-50% of adults are positive for the Philadelphia chromosome (Ph1)[citation needed]. Because these patients have a worse prognosis than other individuals with ALL, many oncologists recommend allogeneic bone marrow transplantation (alloBMT), since remission may be brief following conventional ALL chemotherapy.

People who receive bone marrow transplantation will require protective isolation in the hospital, including filtered air, sterile food, and sterilization of the microorganisms in the gut, until their total white blood cell (WBC) count is above 500.

Recurrent ALL patients usually do not benefit from additional chemotherapy alone. If possible, they should receive re-induction chemotherapy, followed by allogeneic bone marrow transplant (alloBMT).

Alternatively, patients with recurrent ALL may benefit from participation in new clinical trials of alloBMT, immune system agents, and chemotherapeutic agents, or low-dose radiotherapy, if the cancer recurs throughout the body or CNS.

Benzene Lawsuits – Talk to a Benzene Lawyer

If you or a loved one have been diagnosed with acute myelogenous leukemia (AML), myelodysplastic syndrome (MDS), or non-Hodgkin's lymphoma (NHL) then you need to consult with an attorney to discuss a potential benzene exposure lawsuit. Talk to a Board Certified Personal Injury Trial Lawyer, certified by the Texas Board of Legal Specialization, with 30+ years of experience. Call 1-800-883-9858 or click the link below.

Products with Benzene Exposure:
Adhesives
Jet Fuel and Aviation Fuel
Solvents and Degreasers used by automotive mechanics
Bulk refined petroleum products on barges
Denture Adhesives (some)
Brake Cleaning Products
Engine and turbine workers
Gasoline
Paint Thinners and Solvents House painters
Solvents in Industrial plants
Barge Products Maritime workers
Newspaper Print Chemicals
Solvents and Drilling Fluids
Pesticides
Benzene
Xylene
Naphtha
Toluene
Synthetic rubber

Other Benzene Containing Products:
WD 40 Solvent Spray
Liquid Wrench Degreaser
Rust-Ban 392
Sunoco Household Oil
3-In-One Electric Motor Oil
Creosote Lumber
Creosote Railroad Ties
3-In-One Household Oil
Gardner Blacktop Driveway Sealer
Gardner EZ STIR Filler Sealer
Parks Furniture Refinisher
Parks Adhesive Remover
Parks Mineral Spirits Paint Thinner
Parks Lacquer Thinner
Parks Brush Cleaner
Parks PRO liquid Paint Stripper
Parks liquid Strip
Parks Lacquer Thinner 6/13/97
Parks Adhesive Remover 9/4/98
Parks liquid Deglosser 9/4/98
Gumoutregane Premium Gas Treatment
Gumoutxtra 1 Tank Carb Cleaner
Gumouttune Up Spray
Gumoutcarb/Fuel Injector Cleaner (Aerosol)
Gumoutcarb/Fuel Injector Cleaner (liquid)
Gumoutdiesel Fuel System Cleaner
Gumoutcold Weather Diesel Treatment
Gumoutliquid Intake Cleaner
Champion Carb. Cleaner
Champion Flush Off Degreaser
Champion Brake Cleaner
Champion Cold Galvanize
Champion Galv Off
Champion CS+
Champion N/F 4 Way Penetrating Oil
Champion Stainless Steel Cleaner
Champion X It Out Vandal Mark Remover
Champion Super Lubricant
Champion Spray Paint
Champion Flying Insect Killer
Champion Fire Ant Killer
Champion Multi Insect/lice Killer
Champion Indoor Insect Fogger
Champion Ant & Roach
Champion Metered Insecticide
Bonide Grass, Weed & Vegetation Killer
Ortho Weed-B-Gone
Staffel's Screwwork Compound-U.S.
Martin's Formula No. 62 Screw Work Smear for Horses and Mules
Thoroseal Redi Mix Paint
Naptha
VM & P Naptha
Varsol

 

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    NOTE: If you have been exposed to any refined petroleum products or chemicals containing benzene, toluene, xylene, naphtha or any aromatic hydrocarbon at a chemical plant, refinery or used a benzene-containing product and later diagnosed with Acute Myelogenous Leukemia, AML Leukemia, Myelodysplastic Syndromes (MDS), Aplastic Anemia (AA), Multiple Myeloma (MM), or Non-Hodgkin's Lymphoma (NHL), or CLL then you may have a right to file a benzene exposure lawsuit. Call for a Free Confidential Consultation. Do Not Delay. Some states have filing dealings or statutes of limitations that expire as short as one year from the date of diagnosis and/or other strict conditions. Talk to a benzene exposure lawyer and get the help you and your family deserve. 

    All Cases Taken on a Contingency Fee Basis. No Attorney's Fee or Expenses Unless a Recovery Obtained.