Acute lymphocytic leukemia (ALL) is a type of cancer that affects your blood and bone marrow.
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When you’re diagnosed with ALL, you’ll also be diagnosed with a subtype, B-cell or T-cell. Your subtype will affect your treatment.
You’ll likely receive chemotherapy and medication as the first round of treatment. Other treatments will depend on how your body responds to the chemotherapy.
B-cell acute lymphoblastic leukemia is a serious condition, but with treatment, remission is possible.
B-cell acute lymphoblastic leukemia is a type of acute lymphoblastic leukemia (ALL) that causes you to have many immature white blood cells, known as B-cell lymphoblasts, in your bloodstream and bone marrow.
B-cell acute lymphoblastic leukemia is the most common subtype of ALL, and causes 75 percent of ALL cases in adults, according to the Leukemia and Lymphoma Society. It usually progresses quickly.
When you have B-cell acute lymphoblastic leukemia, your system makes the immature white blood cells instead of the mature white blood cells your body needs.
The immature cells do not perform necessary tasks such as fighting infections. As the immature cells build up in your body, there isn’t room for healthy, mature cells.
It’s unclear what causes B-cell acute lymphoblastic leukemia. Like all types of ALL, it can be found in people of all ages and backgrounds.
What scientists do know is that B-cell acute lymphoblastic leukemia occurs when there is a change to the DNA of bone marrow cells.
Typically, the DNA in bone marrow cells manages when the cells grow, divide into new cells, and die off.
The DNA mutation that causes B-cell acute lymphoblastic leukemia interferes with this process. This causes the bone marrow cells to keep growing and dividing.
The growth in bone marrow cells releases the immature white blood cells. The cells then turn into leukemia white blood cells, known as lymphoblasts.
In B-cell acute lymphoblastic leukemia, the affected white blood cells are B-cells.
B-cells help your body fight infection by marking the cells that carry the infection or other dangerous cells with a protein. Cells marked with that protein are then destroyed.
Another type of ALL, T-cell lymphoblastic leukemia, affects your T-cells. T-cells also help your body fight infection.
T-cells directly destroy cells that carry the infection. Your body needs both T-cells and B-cells to fight infections.
Since there is no known cause of B-cell acute lymphoblastic leukemia, there is no way to prevent it.
You can try to avoid any harmful risk factors you can control, such as smoking. However, there is no guarantee that this will prevent you from developing B-cell acute lymphoblastic leukemia.
Although the cause of the cellular DNA mutation that leads to B-cell acute lymphoblastic leukemia is unknown, there are some risk factors that can increase your odds of developing this cancer. Risk factors may include:
- Down syndrome and other genetic disorders. The chromosomal variances responsible for conditions like Down syndrome can also cause an increased risk of developing B-cell acute lymphoblastic leukemia.
- Chemotherapy and other cancer treatments. People living with cancer who have chemotherapy or radiation therapy are at an increased risk of developing B-cell acute lymphoblastic leukemia.
- High levels of radiation. People who experience an exposure to nuclear reactor accidents or other high levels of radiation show an increased risk of developing B-cell acute lymphoblastic leukemia.
- Smoking. Smoking is linked to an increased risk of developing many types of cancer, including B-cell acute lymphoblastic leukemia.
At first, many of the symptoms of B-cell acute lymphoblastic leukemia might seem like the flu.
However, flu symptoms go away after 1 or 2 weeks. Symptoms of B-cell acute lymphoblastic leukemia will not. Some of these symptoms include:
- shortness of breath
- feeling paler than usual or clammy
- night sweats
- nosebleeds that are severe or occur often
- cuts that are slow to stop bleeding and heal
- loss of energy
- bone pain or discomfort
- joint pain
- bleeding gums
- infections that do not heal
- swollen lymph nodes you can feel as lumps under your skin around your neck, stomach, pelvis, or armpits
- menstrual irregularities
- pin-sized red dots on your skin
- unexplained weight loss
Not everyone will experience every symptom listed above. Additionally, having a couple of these symptoms doesn’t necessarily mean you have B-cell acute lymphoblastic leukemia.
Many of these symptoms are also found in less serious conditions. However, if you’ve had any of these symptoms for longer than 2 weeks, it’s a good idea to make an appointment with a doctor.
There are many types of treatment for B-cell acute lymphoblastic leukemia.
The first phase of treatment, known as induction therapy, aims to destroy the lymphoblasts and get your blood cell production stabilized. You’ll be in remission once this occurs, but you’ll still need treatment.
You’ll then have additional treatment, known as post-remission therapy, to destroy any remaining cancer cells in your body.
You’ll typically follow up a few years of what’s called maintenance therapy. Maintenance therapy prevents the cancer cells from regrowing.
Treatments you might receive throughout these phases include:
- Chemotherapy. You’ll receive chemotherapy during the first phase of your treatment to destroy the cancer cells. You might also receive chemotherapy in the post-remission and maintenance therapy phases.
- Radiation. Radiation therapy destroys cancer cells using beams similar to X-rays. You might need radiation if your cancer has spread.
- Targeted therapy. You’ll be prescribed medication to target the “errors” in the cancer cells. This can cause them to die off. Targeted therapy is generally used in the first phase of treatment along with chemotherapy.
- Stem cell transplants. Stem cell transplants replace the bone marrow affected by cancer cells with new, healthy bone marrow. It’s generally used for relapses.
- Immunotherapy. Immunotherapy boosts your body’s natural immune system to help fight cancer. You might receive this treatment if you have a relapse.
- Chimeric antigen receptor (CAR)-T cell therapy. CAR-T cell therapy is a treatment that works with your body’s T-cells to get them to fight the cancer cells. This treatment is generally used in children and young adults.
There are also experimental treatments and clinical trials available for B-cell acute lymphoblastic leukemia.
Your doctor will tell you if you’re a good candidate for any of them. Keep in mind that because these treatments are still being developed, there might be significant risk involved.
Your treatment might look different if you’re 65 or older. Adults in this age group may not respond as well to chemotherapy and other standard treatments for B-cell acute lymphoblastic leukemia.
Your doctor will discuss which treatment options will work best for you if you develop B-cell acute lymphoblastic leukemia at this age.
The outlook for people with B-cell acute lymphoblastic leukemia depends on several factors.
For example, children under 15 years old are significantly more likely to have successful treatment and achieve full remission.
However, new treatments for all types of cancer are helping more people achieve remission than ever before.
Decades ago, all types of leukemia had a five-year survival rate of around 14 percent according to the Leukemia and Lymphoma Society.
Today, the five-year survival rate for ALL specifically is 71.7 percent. This rate is even higher in children.
Your outlook will depend on several individual factors, including:
- Your age at diagnosis. The younger you are, the better your chances are for a complete recovery.
- How you respond to chemotherapy. People who respond to chemotherapy quickly are more like to completely recover.
- Your white blood cell count when you’re diagnosed. People with a lower white blood cell count when they’re diagnosed are more likely to achieve complete recovery.
Most people with B-cell acute lymphoblastic leukemia go into remission. However, many people may relapse and need further treatment.
B-cell acute lymphoblastic leukemia is very likely to be cured if you have been in remission for 5 years or more.
B-cell acute lymphoblastic leukemia is a serious condition that spreads fast. You need to start treatment as soon as possible to help fight the cancer cells multiplying in your body. Treatments can include:
- other therapies
The treatments above may help kill the cancer cells and boost your immune system. A stem cell transplant might be needed if you have a relapse.
The outlook for B-cell acute lymphoblastic leukemia is improving as new treatments become available and doctors gain a better understanding of the condition.