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NCCN Guidelines for Patients



Acute Lymphoblastic Leukemia, Version 1.2017


Cancer treatments

Radiation therapy

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

of age.

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

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.