NCCN Guidelines for Patients
Acute Lymphoblastic Leukemia, Version 1.2017
Considering allogeneic SCT
An allogeneic SCT is a complex treatment and can
cause very serious side effects. Thus, it may not
be a good treatment choice for every patient with
ALL. Many treatment centers will only consider this
treatment option for patients younger than 65 years
Your doctor will look at many factors to help decide
if an allogeneic SCT is a good choice for you. These
factors include your age and general health, certain
prognostic factors, how well other treatments worked,
and if a well-matched donor has been found.
An allogeneic SCT is not used as the first or
main treatment for ALL. It may be used as part
of consolidation therapy for certain patients with
Ph-positive ALL or in patients with other poor risk
features. Doctors may also consider an allogeneic
SCT if prior treatments fail to kill all of the leukemia
cells or keep them away.
Side effects of allogeneic SCT
A side effect is an unhealthy or unpleasant physical
or emotional condition caused by treatment.
Common side effects of chemotherapy, which is
given before the transplant, are described on page
34. You will likely feel tired and weak shortly after the
transplant while waiting for the new blood stem cells
to grow in the bone marrow.
Allogeneic transplants have a high risk of
isease). GVHD is when
the donated cells see the cells in your body as
foreign and attack them. The parts of the body
most commonly damaged by GVHD are the skin,
intestines, and liver.
GVHD is a serious side effect that can cause the
transplant to fail by stopping the donated blood stem
cells from growing in your bone marrow. GVHD can
happen within a few weeks after the transplant or
much later. Your doctor may give you medicine that
suppresses your immune system to try to prevent
this side effect.
Radiation therapy uses high-energy rays to treat
cancer. The rays damage the genes in cells. This
either kills the cancer cells or stops new cancer cells
from being made. Radiation therapy may be given
in different ways. For ALL, radiation therapy is given
from a machine outside the body. This method is
called EBRT (
Radiation therapy is not usually part of the main
treatment for ALL. But, it may be used to treat
leukemia cells that have spread to fluid around the
brain and spinal cord. This is called CNS disease.
To treat CNS disease, radiation therapy is aimed
at the brain and/or spine. Doctors may refer to this
as cranial irradiation or cranial-spinal irradiation.
Radiation therapy may also be used to treat
leukemia cells that have spread to the testicles.
Lastly, radiation therapy can be used as part of the
treatment given prior to an SCT.
During radiation treatment
You will lie down on a treatment table and stay very
still. You will be alone while a technician operates the
EBRT machine from a nearby room. The technician
will be able to see, hear, and speak with you at all
times. As treatment is given, you may hear noises.
A session can take between 15 and 30 minutes.
Radiation therapy is often given 5 days a week for 2
to 3 weeks.