Research into acute lymphoblastic leukaemia (ALL)

Researchers in the UK are looking for better and kinder ways to treat ALL. There is research looking at:

• how ALL develops
• the genetic differences in leukaemia cells
• treatment for people who have ALL that won't go away (refractory) or comes back after treatment (relapsed)

Go to Cancer Research UK’s clinical trials database if you are looking for a trial for ALL in the UK. You need to talk to your specialist if there are any trials that you think you might be able to take part in.

Some of the trials on this page have now stopped recruiting people. It takes time before the results are available. This is because the trial team follow the patients for a period of time and collect and analyse the results. We have included this ongoing research to give examples of what's happening in adult ALL.

This page is about research into ALL for adults. We have separate information about research into childhood ALL.

Research and clinical trials

All cancer treatments must be fully researched before they can be used for everyone.

This is so we can be sure that:

• they work

• they work better than the treatments already available

• they are safe

To make sure the research is accurate, each trial has certain entry conditions for who can take part. These are different for each trial.

Hospitals do not take part in every clinical trial. Some trials are only done in a small number of hospitals, or in one area of the country. You may need to travel quite far if you take part in these trials. 

Research into treatment for ALL

There are some clinical trials looking at treatment for ALL in the UK and around the world. Researchers are mainly looking at:

• chemotherapy
• stem cell transplants
• targeted cancer drugs
• immunotherapy
• treatment for different age groups

Chemotherapy

Chemotherapy is the main treatment for ALL. Chemotherapy uses anti cancer drugs to destroy cancer cells. This is called cytotoxic treatment. The drugs circulate throughout the body in the bloodstream.

Trials are looking into:

• different combinations of chemotherapy drugs

• reducing chemotherapy side effects

• how chemotherapy affects quality of life

• chemotherapy for different age groups

• different chemotherapy based on whether there is a high risk of the ALL coming back

• combining chemotherapy with other types of treatment

• what works best to prevent the leukaemia from coming back

Stem cell and bone marrow transplants

You might have a stem cell transplant as part of your treatment for ALL. For ALL, you have stem cells from someone else (a donor). This is called an allogeneic transplant. You have chemotherapy before a transplant and sometimes total body irradiation (TBI ) and targeted cancer drugs.

Stem cell transplants can cause severe side effects.

A team of researchers are studying blood samples from patients and donors to get a better understanding of stem cell transplants. They hope the findings will help to improve the success of transplants and reduce the side effects.

Recovery after a transplant

The immune system doesn’t work properly for several months after a transplant. It can take a long time for people to recover and they are more prone to getting an infection.

People living with blood cancers often have antibiotics many times due to their increased risk of infection. Antibiotics can reduce the number of ‘good’ bacteria in the digestive system which reduces the variety of gut microbiome . Research is looking at treatment to bring back the ‘good’ bacteria to support a person’s immune system and help recovery.

GvHD is a complication of donor transplants. The donor’s T cells fight the body’s own tissues, causing problems such as diarrhoea, skin rashes or liver damage. Researchers are focusing on newer combinations of treatment to see if these will reduce the risk of GvHD.

Targeted cancer drugs

Targeted cancer drugs work by ‘targeting’ those differences that help a cancer cell to survive and grow.

Some people with ALL have a change in their leukaemia cells called the Philadelphia chromosome. About 20 to 30 out of every 100 people with ALL (about 20 to 30%) have this change. People who are philidelphia chromosome positive have a targeted cancer drug called imatinib with their chemotherapy.

Research shows that having imatinib as part of induction treatment improves your chances of getting into remission .

There is research looking at different ways of having imatinib with chemotherapy. This is to see if less intensive treatment works as well as standard treatment and how the side effects compare. They also want to find out if having imatinib for longer helps to keep the leukaemia away.

Research teams are also looking into:

• using different targeted cancer drugs

• new targeted cancer drugs alongside chemotherapy

• targeted cancer drugs as a treatment for relapsed and refractory leukaemia

Immunotherapy

Immunotherapies can boost the body's own immune system to fight off or kill cancer cells.

Chimeric antigen receptor T-cell therapy is also called CAR T-cell therapy. It is a type of immunotherapy treatment that is used to treat relapsed and refractory B cell ALL

With this treatment, a specialist nurse collects a certain type of white blood cell, called T cells from your body. These cells help fight infections, but they can't tell the difference between a normal cell and a cancer cell. Experts in a laboratory change your T cells to become CAR T-cells. You have these CAR T-cells back through a drip into your bloodstream. The altered T cells are more able to recognise and attack any leukaemia cells.

Research is now looking at:

• ways to improve the success of CAR T-cell therapy for people with B cell ALL
• CAR-T cell therapy for people with T cell ALL

Treatment for different age groups

Treatment for ALL is different depending on your age. There is no standard treatment for those over 60 years old. So researchers are comparing different combinations of treatment to find out which is best. They will collect information about the side effects that people have and how this affects their quality of life. The researchers are also studying the DNA of those taking part to better understand why some people develop ALL