Understanding ALL
What acute lymphoblastic leukaemia is, what the treatment phases mean, and why it takes about two to three years.
What it is
starts in the , where blood cells are made. Immature white cells multiply and crowd out healthy cells, which is why children often arrive tired, bruised, or with repeated infections.
It is the most common cancer in children. Treatment is long and demanding, but the great majority of children treated on modern protocols are cured.
The phases, in order
Induction (about 4-5 weeks). The most intensive start. The goal is — no leukaemia visible on standard tests. Most children reach it in this phase.
Consolidation and intensification (several months). Deeper treatment aimed at cells that survived induction, including medicine given into the spinal fluid because standard chemotherapy does not reach the brain well.
Maintenance (about 18 months to 2 years). Mostly daily tablets and monthly clinic visits at home. Much gentler. School and normal life largely resume.
Why treatment length does not mean bad news
The long tail of maintenance is not a sign that something went wrong. Shortening it has been tried in trials and led to more relapses. The length is part of what makes the cure rate high.
Ask the team where you are on the . Seeing the map makes the next months far less abstract.
Words you will hear early
Risk group. Standard, intermediate, or high — decided by age, white cell count at diagnosis, genetic features of the leukaemia cells, and how quickly it responds.
. A sensitive test after early treatment. A low result usually means less intensive treatment; a high one means more. It is a tool, not a verdict.
Where this comes from
- Current national ALL protocol summary. Phase names and durations differ between protocols; confirm with your team.
- Paediatric haematology-oncology reference texts. Risk stratification and MRD principles.
Next review due 2027-02-01.