- Chemotherapy
- Radiation
- Chemotherapy uses cytotoxic drugs to kill cancer cells. These may be given either through an IV or as an oral tablet. In general, treatment for acute lymphoblastic leukaemia (ALL) uses lower doses of chemotherapy over a longer period (usually 2 to 3 years).
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The treatment of ALL get divided into four stages –
- Induction therapy- This is the first phase of treatment. The goal of induction therapy is to destroy as many cancer cells as possible to to achieve (induce) remission. The remission induction therapy lasts for 4 to 6 weeks.
- Intensification (consolidation) therapy is a period of intensified treatment administered shortly after remission induction.In addition, some new chemotherapeutic agents are administered to eradicate residual blast cells and tackle the problem of drug resistance.
- Delayed intensification or reinduction – This includes weekly chemotherapy drugs to kill any residual leukemic cells or those that try to come back.
- Maintenance or continuation therapy is done once remission has been achieved; therapy is continued for an additional 2-3 years.Therefore, it is imperative to carefully monitor children on maintenance therapy for drug-related toxicity and compliance.
- Central nervous system involvement at the time of diagnosis is investigated. This is because the CNS is where leukemic cells are protected from systemic chemotherapy due to the blood-brain barrier. Early CNS prophylaxis is essential to eradicate leukemic cells which have passed the blood-brain barrier.
- Treatment after a relapse – The patients may require a Stem cell transplant (Allogeneic transplant) those who have relapsed or have not responded to standard therapy.
- Allogeneic transplant – The doctors can take Blood stem cells from a donor whose bone marrow closely matches the patient. Stem cells may also be collected from a newborn’s umbilical cord/placenta (related). These cells are used to replace diseased stem cells. 
- Supportive Care – Blood and platelet transfusion, detection and management of infectious complications, nutritional/ metabolic needs and psychosocial support are required. A specialist in paediatric oncology should treat these children.
- Radiation therapy uses high-energy beams to kill cancer cells. It is used only in particular cases and is not a primary treatment for leukaemia.However, it may be used when the disease has affected the brain and central nervous system or is likely to spread to these areas. 
