What are the main treatment options for Acute Lymphocytic Leukemia (ALL)?

• A. Chemotherapy, HSCT, monoclonal antibody therapy, and corticosteroids
• B. Surgery and radiotherapy only
• C. Antibiotics and antivirals only
• D. Supportive care only

Answer: (A)

All treatment for acute lymphocytic leukemia relies on a multi-pronged systemic approach to eradicate leukemia cells and prevent relapse. The backbone is multi-agent chemotherapy given in phases (induction to achieve remission, then consolidation/intensification, and sometimes maintenance) to kill leukemic blasts throughout the body and prevent sanctuary sites. Corticosteroids are a key part of these regimens because they rapidly induce apoptosis of lymphoblasts and help shrink disease when combined with chemotherapy.

Monoclonal antibody therapy adds a targeted strike against leukemia cells expressing specific surface antigens, such as CD19 or CD20, enhancing immune-mediated killing and improving remission rates in appropriate subtypes. Hematopoietic stem cell transplantation is used as a potential curative option for high-risk or relapsed disease, providing a strong consolidating therapy after remission in selected patients.

Surgical removal or radiotherapy are not standard primary treatments for ALL, and supportive care alone cannot cure the leukemia, though antibiotics and antivirals remain important for managing infections during treatment. The combination of chemotherapy, HSCT when indicated, monoclonal antibody therapy, and corticosteroids reflects the main treatment strategy for ALL.