Acute Lymphoblastic Leukaemia Treatment in Delhi

A diagnosis of Acute Lymphoblastic Leukaemia (ALL) in your child or loved one can feel overwhelming, but there is genuine reason for hope. With early diagnosis and timely, protocol-based treatment under the care of experienced specialists like Dr Satyendra Katewa, most children respond very well to therapy. They can return to active, healthy lives. Advances in modern ALL treatment in India, using risk-adapted chemotherapy, targeted therapies where indicated, and comprehensive supportive care, have led to excellent survival outcomes, with cure rates in children reported to be over 90% in appropriately treated early-risk cases.

What Is Acute Lymphoblastic Leukaemia?

Acute Lymphoblastic Leukaemia (ALL) is the most common childhood cancer, accounting for approximately 25% of all paediatric cancers. It’s a type of blood cancer that starts in your bone marrow, the soft tissue inside bones where blood cells are made. In ALL, immature lymphocytes (a type of white blood cell) grow abnormally and rapidly, crowding out healthy blood cells.

This leads to three main problems:

• Anaemia (low red blood cells) causes tiredness and weakness
• Low normal white blood cells make it harder to fight infections
• Low platelets cause easy bruising and bleeding

Acute Lymphoblastic Leukaemia requires prompt medical attention to prevent serious complications and achieve the best outcomes. The good news is that ALL is one of the most curable childhood cancers.

Types of Acute Lymphoblastic Leukaemia

ALL is classified into different types based on which lymphocytes are affected and their genetic characteristics. Understanding your specific type is crucial as it directly influences your ALL treatment plan and prognosis.

B-cell ALL (B-ALL)

The most common type accounts for approximately 85% of childhood ALL cases. B-cell ALL arises in immature B lymphocytes, which usually produce antibodies to fight infections.

Subtypes include:

• Common B-ALL: Most frequent subtype with excellent prognosis
• Pre-B-ALL: Good response to treatment
• Mature B-ALL (Burkitt leukaemia): Rare but highly treatable with intensive therapy

T-cell ALL (T-ALL)

Accounts for approximately 15% of childhood ALL cases. T-cell ALL arises in immature T lymphocytes that typically help regulate the immune system. It often presents with higher white blood cell counts and may involve the thymus gland in the chest.

Philadelphia Chromosome-Positive ALL (Ph+ ALL)

A specific subtype with a chromosomal abnormality called the Philadelphia chromosome. More common in adults than in children. Requires specialised targeted therapy for ALL with tyrosine kinase inhibitors alongside chemotherapy.

Risk Groups

Standard Risk: Younger age (1-9 years), lower white blood cell count, favourable genetics, good treatment response. Cure rates exceed 90%.

High Risk: Age under 1 year or over 10 years, high white blood cell count, unfavourable genetics, poor initial treatment response, or CNS involvement. Requires more intensive treatment but still achieves excellent cure rates of 75-85%.

Recognising Symptoms of Acute Lymphoblastic Leukaemia

Early symptoms of Acute Lymphoblastic Leukaemia can be vague and easily mistaken for common childhood illnesses. However, recognising these signs early makes a significant difference.

Common Warning Signs

Persistent tiredness or weakness: Children appearing exhausted, reluctant to play, or needing frequent naps

Frequent infections: Recurring fevers, chest infections, or mouth sores

Easy bruising or bleeding: Large bruises from minor bumps, frequent nosebleeds, bleeding gums, or tiny red spots on skin (petechiae)

Pale skin: Washed-out or unusually pale appearance

Bone or joint pain: Limping, refusing to walk, or complaining of leg pain (often mistaken for “growing pains”)

Swollen lymph nodes: Painless lumps in the neck, underarms, or groin

Abdominal swelling: Enlarged liver or spleen causing tummy discomfort or feeling full quickly

Shortness of breath: Difficulty breathing or breathlessness during normal activities

Unexplained fever: Persistent fever without obvious infection

Loss of appetite and weight loss: Refusing food and losing weight without trying

Leukaemia Symptoms in Children

Leukaemia symptoms in children may also include:

• Irritability or behavioural changes
• Headaches or vision problems (if leukaemia affects the brain or spinal fluid)
• Facial swelling (if the thymus gland is enlarged in T-ALL)
• Reluctance to engage in usual activities

Important: If your child experiences several symptoms lasting more than 1-2 weeks, especially bone pain with fatigue and bruising, seek immediate evaluation from a paediatric haemato-oncologist. With early detection and expert care, the vast majority of children achieve a cure.

What Causes Acute Lymphoblastic Leukaemia?

The exact causes of Acute Lymphoblastic Leukaemia aren’t fully understood, but doctors have identified several ALL risk factors:

Genetic syndromes: Down syndrome, Li-Fraumeni syndrome, Fanconi anaemia, and ataxia-telangiectasia increase risk.

Previous cancer treatment: Prior chemotherapy or radiation for another cancer increases risk.

High-dose radiation exposure: Exposure to high levels of radiation, though this is rare in children.

Immune system problems: Certain inherited immune deficiencies or immunosuppression after an organ transplant.

Age: ALL is most common in children aged 2-5 years, with a smaller peak in adults over 50.

Gender: Slightly more common in males than females.

Ethnicity: Higher rates in Hispanic and white children compared to African and Asian children.

Twin siblings: If one identical twin develops ALL before age 6, the other twin has an increased risk.

Important Note: ALL is NOT contagious. You cannot “catch” leukaemia from another person. Most children with ALL have no identifiable risk factors. Having risk factors doesn’t mean your child will definitely develop ALL.

How is ALL Diagnosed?

At Dr Satyendra Katewa’s centre in Delhi, ALL diagnosis and treatments follow internationally recognised guidelines, including NCCN, WHO, and ICMR protocols to ensure accuracy and optimal outcomes.

Key Diagnostic Tests

ALL Blood Test (Complete Blood Count): A simple blood draw reveals abnormal blood counts and may show blast cells. This is usually the first test that raises suspicion of leukaemia.

Bone Marrow Examination ALL: Taking a small sample from the hip bone confirms the diagnosis. This procedure is done under sedation or anaesthesia for children to ensure comfort. It determines the percentage of blast cells (20% or more confirms ALL) and identifies the specific ALL subtype.

Genetic and Molecular Testing: Modern ALL diagnosis and treatment rely on detailed genetic profiling:

• Cytogenetics: Identifies chromosomal changes like the Philadelphia chromosome
• Molecular testing: Detects specific gene mutations guiding targeted therapy for ALL
• Flow cytometry: Characterises cell surface markers to distinguish B-ALL from T-ALL

Lumbar Puncture (Spinal Tap): Checks if leukaemia has spread to the cerebrospinal fluid around the brain and spine. This is crucial, as treatment differs depending on CNS involvement.

Imaging Studies: Chest X-ray or CT scan to assess for an enlarged thymus or lymph nodes, particularly in T-ALL.

Additional Blood Tests: Liver and kidney function, electrolytes, uric acid, and infection screening.

Each family receives a clear, compassionate explanation of test findings. We ensure you understand every step of your child’s diagnosis and care journey.

Can Acute Lymphoblastic Leukaemia Be Cured?

Yes, Acute Lymphoblastic Leukaemia is one of the most curable childhood cancers. The ALL survival rate has improved dramatically, with current cure rates exceeding 90% in children and 40-50% in adults. This remarkable success is due to advances in chemotherapy for ALL, targeted therapy for ALL, risk-adapted treatment, and comprehensive supportive care.

What Influences ALL Prognosis?

Age: Children aged 1-9 years have the best outcomes, with cure rates over 90%. Infants under 1 year and adolescents/adults require more intensive treatment.

White blood cell count at diagnosis: Lower counts predict better outcomes.

ALL subtype: B-ALL generally has a better prognosis than T-ALL, though both are highly curable.

Genetic features: Certain chromosomal changes predict favourable (hyperdiploidy, ETV6-RUNX1) or unfavourable outcomes (Philadelphia chromosome, KMT2A rearrangements).

Treatment response: Rapid blast clearance and achieving minimal residual disease (MRD) negativity predict excellent outcomes.

CNS involvement: Leukaemia in the spinal fluid requires additional treatment, but doesn’t significantly reduce cure rates with modern therapy.

Current Success Rates

• Children (1-9 years) with standard risk: Over 95% long-term survival
• Children with high-risk features: 75-85% long-term survival
• Adolescents and young adults: 70-80% long-term survival with paediatric protocols
• Adults: 40-50% long-term survival, improving with newer therapies

These exceptional results make ALL a success story in paediatric oncology.

Treatment Options for Acute Lymphoblastic Leukaemia

At Dr. Satyendra Katewa’s centre, every patient receives evidence-based, risk-adapted care using the latest ALL treatment options. Treatment is personalised to your child’s specific ALL subtype, genetic features, age, and treatment response.

1. Chemotherapy for ALL

Chemotherapy for ALL is the primary treatment and follows a carefully structured protocol over 2-3 years:

Induction Phase (4-6 weeks)

The first intensive treatment phase aims to destroy leukaemia cells and achieve complete remission. Multiple chemotherapy drugs are used, including:

• Vincristine, daunorubicin, or doxorubicin
• L-asparaginase
• Corticosteroids (prednisolone or dexamethasone)
• Intrathecal chemotherapy (into spinal fluid)

Success rate: Over 95% of children achieve complete remission after induction.

Consolidation/Intensification Phase (4-8 months)

Additional intensive chemotherapy cycles eliminate remaining hidden leukaemia cells and prevent relapse. This phase includes high-dose methotrexate, cytarabine, and other agents based on risk group.

Maintenance Phase (2-3 years total treatment)

Long-term daily and weekly chemotherapy maintains remission:

• Daily oral mercaptopurine
• Weekly oral methotrexate
• Monthly vincristine and corticosteroid pulses
• Regular intrathecal chemotherapy

Maintenance continues for approximately 2-3 years from diagnosis; longer treatment duration improves cure rates.

Managing ALL Chemotherapy Side Effects

Common ALL chemotherapy side effects include:

• Temporary bone marrow suppression (requiring blood transfusions)
• Nausea and vomiting (well-controlled with anti-sickness medications)
• Hair loss (temporary; hair regrows during maintenance)
• Mouth sores
• Increased infection risk (requiring antibiotics and careful monitoring)
• Corticosteroid effects (increased appetite, mood changes, temporary weight gain)
• Fatigue

Dr. Katewa’s team provides comprehensive supportive care, including infection prevention, nutritional support, growth monitoring, and psychosocial counselling for children and families.

2. Targeted Therapy for ALL

Targeted therapy for ALL uses medications that specifically attack leukaemia cells with specific genetic abnormalities:

Tyrosine kinase inhibitors (imatinib, dasatinib): Essential for Philadelphia chromosome-positive ALL, with dramatic improvements in outcomes when combined with chemotherapy.

Monoclonal antibodies:

• Rituximab: Targets CD20 on mature B-ALL cells
• Blinatumomab: Bispecific antibody engaging T-cells to kill B-ALL cells
• Inotuzumab ozogamicin: Antibody-drug conjugate for CD22-positive ALL

CAR T-cell therapy: Revolutionary treatment where patient’s own T-cells are genetically modified to recognise and destroy leukaemia cells. Reserved for relapsed/refractory cases with remarkable success rates.

These precision medicines have transformed outcomes, particularly for high-risk and relapsed ALL.

3. Central Nervous System (CNS) Treatment

Preventing and treating CNS leukaemia is crucial. All patients receive:

• Intrathecal chemotherapy: Medications injected into the spinal fluid during lumbar punctures
• High-dose systemic chemotherapy: Crosses the blood-brain barrier
• Cranial radiation: Reserved for specific high-risk situations in older children

Modern protocols minimise radiation use to protect developing brains whilst maintaining excellent CNS disease control.

4. Bone Marrow Transplant for ALL

Bone marrow transplant for ALL (stem cell transplant) is reserved for:

• Very high-risk ALL at initial diagnosis
• Relapsed ALL after achieving second remission
• ALL that doesn’t respond to initial treatment

Allogeneic transplant uses matched donor stem cells, offering the best chance for a cure in these challenging situations. The transplant process includes high-dose conditioning chemotherapy, stem cell infusion, engraftment period, and careful recovery monitoring.

Whilst carrying risks including infection and graft-versus-host disease, transplant has helped many children achieve lasting ALL remission and recovery.

5. Supportive Care

Throughout ALL treatment in India, families receive:

• Blood and platelet transfusions
• Antibiotics, antivirals, and antifungals for infection prevention and treatment
• Nutritional support and growth monitoring
• Pain management
• Central line care (Port-a-Cath or Hickman catheter)
• Psychosocial support for the child and family
• Educational support and school liaison
• Fertility preservation counselling when appropriate

ALL Treatment for Children (Paediatric ALL Treatment)

Children and adolescents with ALL require specialised paediatric ALL treatment from an experienced paediatric haemato-oncologist who understands their unique needs. At Dr Satyendra Katewa’s centre in Delhi, care is personalised to maximise cure rates whilst minimising long-term effects on growth, development, and quality of life.

What Makes Paediatric ALL Treatment Special?

Age-appropriate protocols: Drug dosing and selection tailored to children’s physiology and developmental stage.

Risk-adapted therapy: Treatment intensity adjusted based on individual risk factors—not giving more treatment than necessary.

Long-term follow-up: Monitoring growth, development, learning, cardiac function, and other potential late effects.

Family-centred care: Supporting parents, siblings, and the entire family through diagnosis, treatment, and beyond.

Child life services: Play therapy, psychological support, and age-appropriate education about treatment.

School integration: Helping children maintain connections with school and friends during treatment.

Excellent outcomes: Children with ALL treated on modern protocols achieve cure rates exceeding 90%, with most returning to completely normal lives.

ALL Treatment for Adults

Adult ALL treatment has improved significantly through the adoption of paediatric-inspired protocols. Adults receive:

Intensive chemotherapy: Similar to paediatric regimens but adjusted for adult tolerance.

Targeted therapy: Tyrosine kinase inhibitors for Ph+ ALL, monoclonal antibodies, and novel agents.

Bone marrow transplant: More frequently recommended in adults, particularly for high-risk features or Ph+ ALL in first remission.

Clinical trials: Access to promising new therapies, including CAR T-cell therapy and newer targeted agents.

Adolescents and young adults (ages 15-30) achieve better outcomes when treated on paediatric protocols by experienced paediatric haemato-oncologists.

Understanding Your Child’s ALL Prognosis

Every parent wants to know their child’s ALL prognosis. The ALL survival rate in children is excellent, with over 90% achieving long-term remission. Your child’s individual outlook depends on:

Risk classification: Standard-risk patients have over 95% cure rates; high-risk patients achieve 75-85% cure rates.

Treatment response: Rapid blast clearance and negativity for minimal residual disease predict excellent outcomes.

Genetic features: Certain favourable mutations predict cure rates approaching 98-99%.

Age: Children aged 1-9 years have the best outcomes.

Important: Modern ALL treatment options continue improving outcomes. Your child’s care team will discuss their specific prognosis honestly and compassionately, providing realistic hope grounded in medical evidence.

Why Choose Dr Satyendra Katewa for ALL Treatment?

As a leading paediatric haemato-oncologist and recognised Acute Lymphoblastic Leukaemia specialist in Delhi, Dr Satyendra Katewa combines medical excellence with compassionate, family-centred care.

Expertise & Success

• Extensive experience in treating paediatric ALL with excellent cure rates
• Expert in risk-adapted chemotherapy protocols and targeted therapy for ALL
• Recognised as one of the best ALL doctors in India
• Regular participation in national and international paediatric oncology conferences

Comprehensive Paediatric Cancer Care

• Advanced genetic testing and risk stratification
• Minimal residual disease monitoring for precise treatment adjustment
• Management of ALL chemotherapy side effects with modern supportive care
• Infection prevention and treatment expertise
• Central line care and maintenance
• Nutritional counselling and growth monitoring
• Long-term survivorship care

Family-Centred Approach

• Clear, honest communication in language families understand
• Compassionate support for the emotional and practical needs of the entire family
• Sibling support and family counselling
• Connection to support groups and other families
• School liaison and educational planning

Excellent Outcomes

• Cure rates exceeding 90% for childhood ALL
• Comprehensive protocols following international guidelines (NCCN, COG, WHO)
• Access to the latest therapies, including targeted agents and clinical trials when appropriate
• Focus on not just the cure but the quality of life and normal development

“Every child deserves the best possible chance for a cure and a normal, healthy future. We combine the most advanced treatments with compassionate care that supports the whole family.” – Dr Satyendra Katewa

Support for International Patients

Dr Satyendra Katewa’s team provides comprehensive support for international patients seeking ALL treatment in Delhi:

Medical visa facilitation and documentation, transparent treatment cost estimates, pre-arrival consultation, airport pickup, family accommodation assistance, interpreter services, coordination with home country oncologists, and online follow-up after returning home.

India offers world-class paediatric leukaemia treatment at significantly lower costs than in Western countries, with excellent outcomes that match or exceed international standards.

Your Child’s Journey Toward Healing

Achieving ALL remission and recovery is highly likely with prompt diagnosis and expert treatment. Over 90% of children are cured and return to completely normal lives. Dr Satyendra Katewa and his dedicated team will support your family every step of the way, providing:

• Expert medical care using the latest ALL treatment options
• Comprehensive management of side effects
• Emotional support for the child and family
• Hope grounded in excellent cure rates
• Long-term follow-up to ensure your child thrives

Most children complete treatment and return to school, sports, and all normal childhood activities. Many ALL survivors grow up to have successful careers, marry, and have healthy children of their own.

Book Your Consultation

If your child has been diagnosed with Acute Lymphoblastic Leukaemia or experiences symptoms of Acute Lymphoblastic Leukaemia, seek immediate evaluation. Early diagnosis and treatment by a paediatric haemato-oncologist significantly improves outcomes.

Schedule a consultation with Dr. Satyendra Katewa to receive:

• Comprehensive diagnostic assessment, including ALL blood test and bone marrow examination
• Personalised ALL treatment plan based on risk classification and genetic features
• Clear explanation of treatment phases and expected timeline
• Guidance on managing ALL chemotherapy side effects
• Support throughout your journey toward ALL remission and recovery
• Honest, compassionate discussion of your child’s ALL prognosis

There is hope. There is an excellent chance for a cure. And there is a team dedicated to your child’s healing.

References & Medical Sources

• National Comprehensive Cancer Network (NCCN) Guidelines for ALL
• Children’s Oncology Group (COG) Protocols
• World Health Organisation (WHO) Classification
• Indian Council of Medical Research (ICMR) Paediatric Oncology Guidelines
• National Medical Commission (NMC) Standards
• European Society for Paediatric Oncology (SIOP) Guidelines

All information follows NMC and MCI guidelines and has been medically reviewed by qualified paediatric haematology-oncology specialists.