Reporting of side effects: If your child experiences any side effects, talk to their doctor, pharmacist or nurse. This includes any possible side effects not listed in the package leaflet. You can also report side effects directly via the Yellow Card Scheme at www.yellowcard.mhra.gov.uk or search for MHRA Yellow Card in the Google Play or Apple App Store.
What is Acute Lymphoblastic Leukaemia (ALL)?
ALL is a type of cancer of the blood and bone marrow, the spongy tissue inside your bones where blood cells are made.(1)
The word ‘acute’ in ALL means that the disease progresses rapidly and creates immature blood cells, rather than mature ones.(2)
The ‘lymphoblastic’ in ALL refers to the white blood cells called lymphocytes, and ALL affects these cells. ALL is also known as acute lymphocytic leukaemia.(3)
ALL has various types and subgroups, including B-cell ALL, T-cell ALL, and Philadelphia positive ALL.(1)
ALL is the most common type of cancer in children(4)
Hi! I'm Rory Raspberry, the superhero who helps to fight against Acute Lymphoblastic Leukaemia, also known as ALL, and I'm here to teach you all about it
What causes ALL?
Throughout your whole life your body makes cells to enable it to function. There are many different types of cells in your body. Sometimes these cells do not always develop in the right way.(2)
For people with ALL, the bone marrow produces bad blood cells that develop into leukaemic white blood cells called lymphoblasts. These bad blood cells are unable to function properly, and they can build up and crowd out healthy blood cells, making you feel poorly.(2)
It is a bit like when you fill the bath with lovely warm water and then someone turns on the cold tap by accident and all the lovely warm water is replaced with cold, so it is not very nice.
ALL Treatment Options
The purpose of ALL treatment is to quickly and efficiently remove the bad cells, to encourage the production of normal cells.(5)
Chemotherapy
Chemotherapy is the main treatment for ALL.(1) It involves the use of drugs to destroy the bad cells. Chemotherapy can be administered by intravenous (IV) tube, injection (into the muscle, or into the fluid around the spine or brain), or orally as a tablet or liquid.(6)
Chemotherapy for ALL is divided into different phases. These are:(1)
- Induction: The purpose of the induction phase is to kill as many cancer cells as possible to achieve remission. This implicates the absence of leukaemia cells in bone marrow samples, the restoration of healthy marrow cells, and the return of blood counts to normal range.
- Consolidation: Doctors understand that even if your leukaemia is in remission following the induction phase, it is important to continue the treatment to prevent the cancer cells from coming back (relapse). Therefore, the goal of the consolidation phase is to further eliminate any remaining leukaemia cells in your body.
- Maintenance: This is the last phase of ALL treatment. It is intended to prevent the condition from returning once you are in remission.
Targeted Therapies
Targeted therapies are highly specialised cancer treatments. The drugs target specific genes and proteins that participate in the growth and survival of cancer cells.(7) Targeted therapies help to block cancer cells and stop them from growing and reproducing.(8)
Some of the most common types of targeted therapies are monoclonal antibodies or small-molecule drugs. In the case of lymphoma, the target drugs block the protein that overproduces B cells.(7) Targeted therapies are usually taken in tablet form.(8)
Stem cell transplant
This involves the transplant of a donor’s stem cells. It may increase the chance of curing ALL, but it comes with significant risks and serious side effects. Before recommending transplantation, doctors will weigh the possibility of further complications.(9)
Chimeric Antigen Receptor (CAR)-T cell therapy
With this specialist treatment, T-cells are extracted from the patient’s blood and undergo modification in the laboratory. This involves introducing a gene for a receptor known as CAR. The patient will then be reintroduced to the CAR-T cells, which possess the ability to identify and attack the cancer cells.(1)
Radiotherapy
Radiotherapy is a special treatment that helps to stop the cancer cells from growing.(10)
Advice for parents and carers
How do I encourage my child to take their medication?
There are many ways to help your child adhere to their treatment; one of the most important being the offer of love and emotional support.
When it comes to their pain and symptoms, making sure they take their medicine and do not regularly miss doses is incredibly important.(11)
Here are some tips which may help if your child is struggling with taking their medication:(11)
A positive attitude
Your attitude towards your child’s medication will influence how they view their medicine. You may find it encouraging for your child to discuss the benefits of the medication and motivate them to take it each day.(11)
Help from family and friends
Sometimes, someone other than a parent or guardian can help to encourage your child to take their medicine. This could be an older sibling, grandparents or even a close family friend.(11)
Rewards
Whether the reward is lots of praise, extra TV time or a bedtime story, rewarding your child for taking their medicine will provide them positive associations with taking their medicine and encourage them to continue taking it.
However, your child should also understand that their medication is an important part of their daily life.(11)
Sticker charts
A sticker chart can be a great way to engage children in their own medication routine. You may even find it helps your child to become more independent and take control.(11)
Please ask your healthcare professional for a copy of our children’s Rory Raspberry activity book
Further support
Please ask your healthcare professional for further clarification on the information given, if required.