y NCCN Guidelines for Patients Version 1.2016 Acute

100 Pages·2016·2.53 MB·English

NCCoNu.orr Ponlelainse co
NGUCICDNELINES g/patieen stumrvpelete
s/ y
s a
FOR PATIENTS® Version 1.2017 urv t
e
y
Acute
Lymphoblastic
Leukemia
Presented with support from:
Available online at NCCN.org/patients
Ü
NCCN Guidelines for Patients®:
Acute Lymphoblastic Leukemia, Version 1.2017
Acute Lymphoblastic Leukemia
LEARNING that you have cancer
can be overwhelming.
The goal of this book is to help you get the best cancer treatment. It explains which
cancer tests and treatments are recommended by experts in acute lymphoblastic
leukemia. The treatments in this book are also used for lymphoblastic lymphoma.
The National Comprehensive Cancer Network® (NCCN®) is a not-for-profit
alliance of 27 leading cancer centers. Experts from NCCN have written treatment
guidelines for doctors who treat acute lymphoblastic leukemia. These treatment
guidelines suggest what the best practice is for cancer care. The information in
this patient book is based on the guidelines written for doctors.
This book focuses on the treatment of acute lymphoblastic leukemia. Key points
of the book are summarized in the related NCCN Quick Guide™. NCCN also
offers patient resources on chronic lymphocytic leukemia, chronic myelogenous
leukemia, multiple myeloma, and other cancer types. Visit NCCN.org/patients for
the full library of patient books as well as other patient and caregiver resources.
NCCN Guidelines for Patients®:
Acute Lymphoblastic Leukemia, Version 1.2017 1
About
These patient guidelines for cancer care are produced by the National
Comprehensive Cancer Network® (NCCN®).
The mission of NCCN is to improve cancer care so people can live better lives. At
the core of NCCN are the NCCN Clinical Practice Guidelines in Oncology (NCCN
Guidelines®). NCCN Guidelines® contain information to help health care workers
plan the best cancer care. They list options for cancer care that are most likely to
have the best results. The NCCN Guidelines for Patients® present the information
from the NCCN Guidelines in an easy-to-learn format.

Panels of experts create the NCCN Guidelines. Most of the experts are from
NCCN Member Institutions. Their areas of expertise are diverse. Many panels
also include a patient advocate. Recommendations in the NCCN Guidelines are
based on clinical trials and the experience of the panelists. The NCCN Guidelines
are updated at least once a year. When funded, the patient books are updated to
reflect the most recent version of the NCCN Guidelines for doctors.
For more information about the NCCN Guidelines, visit NCCN.org/clinical.asp.
Dorothy A. Shead, MS Laura J. Hanisch, PsyD Rachael Clarke
Director, Patient and Medical Writer/Patient Guidelines Data and
Clinical Information Information Specialist Layout Coordinator
Operations
Alycia Corrigan
Medical Writer
NCCN Foundation was founded by NCCN to raise funds for patient education
based on the NCCN Guidelines. NCCN Foundation offers guidance to people
with cancer and their caregivers at every step of their cancer journey. This is done
by sharing key information from leading cancer experts. This information can be
found in a library of NCCN Guidelines for Patients® and other patient education
resources. NCCN Foundation is also committed to advancing cancer treatment
by funding the nation’s promising doctors at the center of cancer research,
education, and progress of cancer therapies.
For more information about NCCN Foundation, visit NCCNfoundation.org.
© 2017 National Comprehensive Cancer Network, Inc. Posted 07/24/2017.
All rights reserved. NCCN Guidelines for Patients® and illustrations herein may not be reproduced in any form for any purpose without the express written permission of
NCCN. The NCCN Guidelines are a work in progress that may be redefined as often as new significant data becomes available. The NCCN makes no warranties of any
kind whatsoever regarding their content, use, or application and disclaims any responsibility for their application or use in any way.
National Comprehensive Cancer Network (NCCN) • 275 Commerce Drive, Suite 300 • Fort Washington, PA 19034 • 215.690.0300
NCCN Guidelines for Patients®:
Acute Lymphoblastic Leukemia, Version 1.2017 2
Supporters
Endorsed in part by
The Leukemia & Lymphoma Society
LLS is dedicated to developing better outcomes for blood cancer patients through research,
education and patient services and is happy to have this comprehensive resource available
to patients. www.LLS.org/informationspecialists
NCCN Guidelines for Patients®:
Acute Lymphoblastic Leukemia, Version 1.2017 3
NCCN Guidelines for Patients®:
Acute Lymphoblastic Leukemia, Version 1.2017 4
Acute Lymphoblastic Leukemia
Contents
6 How to use this book
7 Part 1
Acute lymphoblastic leukemia
Explains how and where this type of cancer starts.
13 Part 2
Testing for ALL
Describes the tests used to confirm this type of cancer and plan treatment.
26 Part 3
Treatment planning
Explains the main factors doctors use to plan treatment that’s right for you.
30 Part 4
Overview of cancer treatments
Describes the types of treatments that are used for ALL.
44 Part 5
Treatment guide
Presents treatment options based on your health and age as well as the features of the cancer.
69 Part 6
Making treatment decisions
Offers tips for choosing the best treatment for you.
77 Glossary
Dictionary
Acronyms
87 NCCN Panel Members
88 NCCN Member Institutions
90 Index
NCCN Guidelines for Patients®:
Acute Lymphoblastic Leukemia, Version 1.2017 5
How to use this book
Who should read this book? Does this book include all
options?
Leukemia is a type of cancer that starts in
blood-forming cells in the bone marrow. Acute This book includes information for many people.
lymphoblastic leukemia is a fast-growing type of Your treatment team can point out what applies to
leukemia that causes too many immature blood cells you. They can also give you more information. While
called lymphoblasts to be made in the bone marrow. reading, make a list of questions to ask your doctors.
Lymphoblastic lymphoma is similar, but it causes
too many lymphoblasts to build up in lymph nodes The treatment options are based on science and
or other parts of the lymphatic system. Patients and the experience of NCCN experts. However, their
those who support them—caregivers, family, and recommendations may not be right for you. Your
friends—may find this book helpful. It may help you doctors may suggest other options based on your
discuss and decide with your doctors what care is health and other factors. If other options are given,
best. ask your treatment team questions.
Are the book chapters in a Help! What do the words
certain order? mean?
Early chapters explain concepts that are repeated in In this book, many medical words are included.
later chapters. Starting with Part 1 may be helpful for These are words that your treatment team may say
many people. It explains what acute lymphoblastic to you. Most of these words may be new to you. It
leukemia is. Knowing more about this cancer may may be a lot to learn.
help you better understand its treatment.
Don’t be discouraged as you read. Keep reading and
Part 2 covers health tests and other care needed review the information. Ask your treatment team to
before starting treatment. Factors that help doctors explain a word or phrase that you do not understand.
plan treatment are described in Part 3.
Words that you may not know are defined in the
Part 4 briefly describes all the types of treatment. text or in the Dictionary. Acronyms are also defined
Knowing what a treatment is will help you understand when first used and in the Glossary. Acronyms are
your options. Treatment options are presented in short words formed from the first letters of several
Part 5. Lastly, Part 6 shares questions for your words. One example is ALL for acute lymphoblastic
doctors and directs you to online resources. leukemia.
NCCN Guidelines for Patients®:
Acute Lymphoblastic Leukemia, Version 1.2017 6
1
Acute lymphoblastic leukemia
8 Lymphoblasts
9 About ALL
12 Symptoms of ALL
12 Review
NCCN Guidelines for Patients®:
Acute Lymphoblastic Leukemia, Version 1.2017 7
1 Acute lymphoblastic leukemia Lymphoblasts
You’ve learned that you have or may have Platelets help control bleeding. Red blood cells carry
ALL. Part 1 explains some basics about oxygen throughout the body. White blood cells help
this cancer that may help you talk with fight germs and infections in the body. They are part
your doctor. These basics may also help of your body’s disease-fighting system—called the
you start planning for treatment. immune system.
Lymphoblasts are a type of very young white blood
cells. Over time, they become mature white blood
cells called lymphocytes. Lymphocytes are mostly
Lymphoblasts
found in the blood and lymphatic system.
Blood is made of many types of cells. The three main The two main types of lymphocytes are
types are platelets, red blood cells, and white blood B-lymphocytes (B-cells) and T-lymphocytes (T-cells).
cells. Each type of blood cell has a different job. B-cells make antibodies that mark germs for killing.
T-cells alert your body that germs are present, kill
diseased cells, and help B-cells work.
Figure 1
Blood cells in bone
marrow
Bone marrow is the soft,
sponge-like tissue in the
center of most bones.
Blood stem cells in the
bone marrow make all
types of blood cells.
Illustration Copyright © 2017 Nucleus Medical Media, All rights reserved. www.nucleusinc.com
NCCN Guidelines for Patients®:
Acute Lymphoblastic Leukemia, Version 1.2017 8