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NCCN Guidelines for Patients



Acute Lymphoblastic Leukemia, Version 1.2017


lumbar puncture

A procedure in which a thin needle is inserted between the

bones of the spine to remove a sample of spinal fluid or give

drugs into the spinal fluid.

lymph node

A small group of disease-fighting cells.

lymphatic system

A network of organs and tissues in the body that collects

and transports a fluid (lymph) and fights germs. This system

includes the bone marrow, lymph nodes, lymph vessels,

thymus, and spleen.


An immature cell that becomes a mature white blood cell

called a lymphocyte.

lymphoblastic lymphoma

A fast-growing cancer that starts in the lymphatic system

and causes too many lymphoblasts to build up in lymph

nodes or other parts of the lymph system.


A type of white blood cell that helps protect the body from

infection and disease.

magnetic resonance imaging (MRI) scan

A test that uses radio waves and powerful magnets to make

pictures of the inside of the body.


The third round (phase) of treatment that is given to keep up

(maintain) good treatment results.


A tool that uses lenses to see things the eyes can’t.

minimal residual disease (MRD)

A very small amount of cancer cells left in the body after

treatment that can’t be seen with a microscope.

monoclonal antibody

A type of immune system protein that is made in a lab and

can attach to a certain target, such as a substance on the

surface of cancer cells.

multiagent chemotherapy

The use of two or more cancer drugs.


Includes many doctors and other health care professionals

who are experts in different areas of cancer care.


An abnormal change.


A doctor who’s an expert in testing cells and tissue to find



Based on treatment designed for or given to children.

pediatric protocol

A detailed plan of a medical treatment for children.

pediatric regimen

A treatment plan that specifies the drug(s), dose, and

schedule for a course of treatment designed for or given to


Philadelphia chromosome

An abnormal, short chromosome 22 that is formed when

parts of chromosomes 9 and 22 switch with each other. Also

called Ph chromosome.

Ph-negative ALL

The leukemia cells do not contain the abnormal Philadelphia


Ph-positive ALL

The leukemia cells contain the abnormal Philadelphia


physical exam

A review of the body by a health expert for signs of disease.


A type of blood cell that helps control bleeding.

polymerase chain reaction (PCR)

A sensitive lab test that is used to look for abnormal

changes in a cell’s genes (coded instructions for controlling

cells) and chromosomes (long strands of genes).

poor risk feature

Something linked with a higher chance (risk) that cancer will

come back after treatment.

positron emission tomography (PET) scan

A test that uses radioactive material to take pictures of the

inside of the body.

postremission therapy

Treatment given after all signs and symptoms of cancer

have disappeared (called a remission) following initial