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Treatment of relapsed or refractory childhood acute lymphoblastic leukemia
Source: Childhood Acute Lymphoblastic Leukemia (PDQ®)–Patient Version, National Cancer Institute.
Source updated: April 15, 2025 · Captured 2026-09-09.
Selected source text with whitespace normalised. This Triangle page is not an NCI PDQ summary. Independent clinical review is pending.
Context: Treatment options for childhood acute lymphoblastic leukemia
Refractory childhood acute lymphoblastic leukemia (ALL) is cancer that does not respond to initial treatment.
Relapsed childhood ALL is cancer that has come back after it has been treated. The leukemia may come back in the blood and bone marrow, brain, spinal cord, testicles, or other parts of the body.
Treatment of relapsed childhood acute lymphoblastic leukemia (ALL) that comes back in the bone marrow may include:
combination chemotherapy with or without immunotherapy (blinatumomab) and/or targeted therapy
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stem cell transplant, using stem cells from a donor
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Other treatments for refractory or relapsed childhood ALL may include:
targeted therapy (inotuzumab, imatinib, or dasatinib)
chimeric antigen receptor (CAR) T-cell therapy
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Treatment of relapsed childhood ALL that comes back outside the bone marrow may include:
systemic chemotherapy and intrathecal chemotherapy with radiation therapy to the brain and/or spinal cord for cancer that comes back in the brain and spinal cord only
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stem cell transplant for cancer that has relapsed in the brain and/or spinal cord, especially if relapse occurs soon after initial diagnosis
combination chemotherapy and radiation therapy for cancer that comes back in the testicles only
Preserved source evidence · Independent clinical review pending · Not medical advice