Treatment planning for B-ALL

• Because B-ALL can develop quickly, your hospital team will want to begin treatment as soon as possible.
• Treatment for B-ALL usually takes around two to three years.
• Your treatment plan will be individual to you, and will depend on many different factors.
• You may have the opportunity to have your treatment as part of a clinical trial.

You will be treated in a specialist haematology or cancer centre by a hospital team that is experienced in treating leukaemia. This is so that you receive the most appropriate treatment and expertise. This might mean that you will be treated in a different hospital to where you were diagnosed.

If you are a young adult

If you are a young adult, you should be given the option to be treated in a teenage and young adult (TYA) unit. These are specialist centres which provide additional support for young adults, including services that can help support your mental, emotional and social well-being.

If you choose not to be treated in your nearest TYA unit, you will be treated in a specialist haematology hospital which is approved to care for young adults.

We have more information about different treatment centres for young adults. It includes some questions you might want to think about if you have a choice about where you’re treated.

There are many different sub-types of B-ALL, and they can behave differently and respond differently to treatment. Because of this, treatment for B-ALL needs to be carefully tailored for each person.

Research from clinical trials over the years has shown that planning treatment based on how likely a person’s B-ALL is to return (relapse), can make a big difference to their chances of being cured. This means that your doctor will carefully consider the risk of the B-ALL relapsing when they’re planning each phase of your treatment.

Your doctor will talk about the details of your diagnosis with other healthcare professionals in a multidisciplinary meeting. They will work together to agree on a treatment plan.

They will consider:

• your age, general health and fitness levels
• how well your body may be able to cope with different types of treatment
• the exact type of B-ALL you have and any genetic changes in your leukaemia cells
• how likely it is that the B-ALL will come back (your risk of relapse)
• your own wishes around treatment.

Your hospital team should explain to you what treatment you will have and when, during each phase. They may be able to give you a chart or diagrams with this information so you can keep track.

At key points throughout your treatment, your doctor will keep discussing your progress with the multidisciplinary team (MDT). They will talk through how well your treatment is working, and how you are coping with it.

Your doctor will talk to you about the aim of your treatment. You may hear this called "treatment intent". For most people, the aim of treatment will be to completely get rid of the leukaemia cells inside their body and cure the B-ALL. This usually involves an intensive treatment plan of about two to three years.

For many people, their treatment works well and they are cured. In some cases, the B-ALL may come back (relapse), and more treatment or different types of treatment may be needed.

You should always be told if the aim of your treatment changes.

There may be reasons why you are not able to have the most intensive treatment that is usually given with the aim of curing the B-ALL. This might be because you have other serious health conditions, or because you are not fit enough to cope with the side effects that can often come with intensive treatment.

If this is the case for you, your doctor will discuss other treatment options with you. Depending on your individual situation, the B-ALL may still be able to be cured with a less-intensive treatment plan.

However, if this isn't possible, the aim of your treatment might instead be to slow down your leukaemia and help manage your symptoms, so that you feel as well as possible, for as long as possible. Unless you have complications like bleeding or infections, you may be able to receive most of your treatment at home. You will still have lots of support and check-ups with your hospital team.

If you have been told that the B-ALL is unlikely to be cured, this might be really tough information to hear. Contact our Support Service if there is anything we can do to support you, or if you want to talk things through.

There may be opportunities to take part in a clinical trial as part of your treatment for B-ALL. Clinical trials aim to find new treatments and improve existing ones. Each has its own eligibility criteria. If you are eligible, your hospital team may discuss with you whether joining a trial is right for you. Taking part in a trial may give you access to new treatments not available outside the study, but it’s always your choice.

If you agree to join a clinical trial, you will receive more information about the trial and how it will work, from your hospital team. Don’t be afraid to voice any questions or concerns you may have. It’s important you feel informed about your treatment.

Your safety and well-being will remain the top priority. You’ll be very closely monitored and have lots of detailed follow-up. You can choose to stop taking part in the clinical trial at any time.

If you do not want to be in a trial, or there is not a trial available that is right for you, you will be offered the best treatment available which is appropriate for your individual condition.

Find out more about what clinical trials are.

If you have recently been diagnosed with ALL and you are under the age of 29, you may be invited to take part in a large clinical trial called ALLTogether1.

This trial is investigating whether treatment for ALL can be made gentler, but just as effective, for people who have a lower chance of their ALL coming back.

ALLTogether1 is also testing whether newer drugs can improve the chance of a cure for people whose ALL is more likely to come back (relapse).

The trial is running until May 2027.

It can feel overwhelming for things to happen so fast. Many people find it hard to fully understand the details of their treatment when they are also trying to cope with the stress of being diagnosed with leukaemia. Your doctor will talk to you about what your treatment plan will involve. Don’t be afraid to ask as many questions as you need to, at any point and if there is anything you don't understand, ask again.

You may want to have a loved one with you whilst your hospital team is talking to you about your treatment, as there can be a lot of information to take in and remember.

Some treatments for B-ALL can affect a person’s ability to get pregnant or make someone pregnant. Sometimes these effects are temporary. However, for people who have very intensive treatment, these effects might last longer or even last forever.

Your hospital team should explain to you before your treatment begins, whether your fertility is likely to be affected, and how long any changes to your fertility are likely to last. They will talk to you about any options you might have to protect your body’s ability to have children in the future (preserve your fertility). This may include freezing eggs, sperm, or embryos before your treatment begins.

For many people with B-ALL however, treatment needs to start very quickly. This often means that there isn’t enough time to preserve your fertility before treatment starts. Some people are able to have fertility preservation at a later stage in their treatment plan, but this is not an option for everyone.

Fertility can be a very personal subject that can bring up a lot of emotions. It’s completely normal to feel uncertain, and to have lots of questions. Your hospital team can help you understand what choices you have and answer your questions. You may be referred to a fertility specialist within your hospital.

At the end of your treatment, you’ll likely have some tests to see how your B-ALL treatment has affected your fertility.

Hearing that treatment for B-ALL will affect or has affected your fertility, can be incredibly tough if this is something that is important to you. It may all feel like a lot to process on top of everything that is already going on.

Don’t be afraid to ask questions and ask for more information if there’s anything that you are not clear about. It’s also important that you make your hospital team aware if you are struggling emotionally, as they may be able to refer you to psychological support.

This information has been accredited with the PIF TICK, the UK's only quality mark for trusted health information.

Last full review June 2026. Next full review due June 2029. We may make factual updates between reviews.

Thank you to Consultant Haematologists Professor Adele Fielding and Dr Clare Rowntree for checking the clinical accuracy of our adult B-cell acute lymphoblastic leukaemia (B-ALL) information.

Thank you also to Karis, Ricky, Binu, Harry, Keri and Jesús for sharing their experiences and for helping with the creation of this information.