B-Cell Acute Lymphoblastic Leukemia: Causes, Symptoms, Diagnosis, Treatments, Support

B-Cell Acute Lymphoblastic Leukemia

Medically Reviewed by Dr. K on 7 May 2021

What Is B-Cell Acute Lymphoblastic Leukemia?

A disease that affects the “B lymphocytes", white blood cells that form in the softcore of your bones called marrow, is known as B-cell acute lymphoblastic leukaemia.

B lymphocytes are supposed to develop into cells that aid in infection defense. However, through this disease, they transform into “leukaemia" cells, which survive longer and replicate more rapidly than regular cells. They accumulate in your bone marrow and then circulate through your bloodstream. They will then spread to other organs in the body.

While it cannot be treated in the vast majority of situations, therapy will help you survive longer and happier. Researchers are still searching for innovative ways to combat the disease.

Keep in mind that you have complete power over your treatment and your livelihood. Engage with family and friends so that you can discuss your plans, worries, and emotions with them. Inquire with your doctor for community services, where you will find individuals who are going through the same thing you are.

Causes

The underlying cause of B-cell acute lymphoblastic leukaemia is still unclear in the majority of cases (B-cell ALL). It does not seem to be a hereditary condition.

If you've received chemotherapy or radiation medication for cancer in the past, for example, the risks of developing B-cell ALL are higher. Additionally, receiving chemotherapy and radiation at the same time can increase the risk.

Symptoms

The amount of leukaemia cells in the body determines your symptoms. Treatments that destroy the cells in the body that trigger leukaemia often eliminate the symptoms.

You may feel sleepy and have a fever when you first develop B-cell ALL. You can also have a loss of appetite and night sweats.

You won't get enough regular blood cells if the leukaemia cells in your bone marrow crowd out the cells that make blood. You may feel tired, dizzy, or light-headed as a result of this.

You can also have the following symptoms:

  • Shortness of breath
  • Recurrent infections
  • Easy bruising
  • Bleeding from the nose or gums on a regular basis

Some symptoms are dependent on where the leukaemia cells migrate in the body. If they migrate to your liver and spleen, for example, they can trigger these organs to enlarge. It's possible that your stomach could expand. And if you just eat a small amount of food, you may feel full.

If the leukaemia cells have spread to your joints or bones, you may experience discomfort. You may see swelling in your neck, underarms, or groin if cancer cells have spread to your lymph nodes.

It's less common, but leukaemia cells may travel to the brain and trigger headaches or coordination problems. Breathing difficulties can result if leukaemia cells reach your chest.

Diagnosis

Your doctor will perform a comprehensive medical exam and also ask about your medical history as well as family history. They will also ask the following:

  • How are your energy levels?
  • Have you ever been lightheaded or weak?
  • Do you have any bruises on your body?
  • Have you been getting sick frequently recently?
  • Do you have frequent nosebleeds or gum bleeding?

Your doctor will also recommend that you undergo several blood testing to determine if you have B-cell ALL:

Full blood count (FBC): This determines how many blood cells, including white blood cells, are in the body.

Peripheral blood smear: This looks for changes in the amount and appearance of blood cells.

These tests may show symptoms of B-cell ALL, such as an excess of young white blood cells or a deficiency of the two other forms of blood cells, red blood cells and platelets.

Bone marrow test: A bone marrow test may also be needed. A sample of your bone marrow would be taken by your specialist, normally from the back of your hip bone. You lay down on a table for this examination and are given an injection to numb the spot. Your specialist will then remove a tiny volume of liquid bone marrow with a needle. The sample would be examined under a microscope by your doctor. The shape and size of the white blood cells would be examined. B-cell ALL may be identified by cells that don't seem to have completely grown.

Your doctor can order tests to see whether B-cell ALL has spread to other parts of your body after it has been diagnosed. An X-ray or a CT scan are two examples. An X-ray utilises low-dose radiation to create images of the body's structures. A CT scan is a sequence of X-rays taken at several perspectives to create accurate pictures of what's going on within the body.

Lumbar puncture: A spinal tap can also be performed on you (lumbar puncture). It examines the brain and spinal cord to see how cancer cells have migrated there. Your doctor will administer an injection to numb your lower back for this examination. Then they use a needle to remove CSF from the region around your spinal cord (cerebrospinal fluid).

Questions for Your Doctor

A new diagnosis of B-cell ALL can be overwhelming and is a lot to process. You may like to ask your doctor the following questions:

  • What stage is my B-cell ALL?
  • What kind of medication would you suggest?
  • Will there be any negative repercussions?
  • What method would you use to track my progress?
  • Are there any current drug research studies that I can be participating in?
  • What is the prognosis for my condition?
Treatments

Since B-cell acute lymphoblastic leukaemia progresses rapidly, it's important to get treatment as soon as possible. You have a variety of treatment options, divided into 3 distinct phases:

  • Induction phase
  • Consolidation phase or post-remission therapy 
  • Maintenance therapy

The first phase's target is “complete recovery," which means killing the leukaemia cells and eliminating all signs. This is referred to as the “induction phase”.

If you achieve recovery, the next step is to eliminate any remaining leukaemia cells that aren't active but may progress later and reactivate the disease. This phase of treatment can be referred to as “consolidation phase" or “post-remission therapy”.

The third phase is known as “maintenance therapy”, and its aim is to keep cancer cells from returning.

Consult the doctor on the right course of action for you. Involve family and friends in your decision making process so they can help you as well.

The following are some of your treatment options:

Chemotherapy

In chemotherapy, medications enter the bloodstream to destroy cancer cells throughout the body. These medications can be provided to you in three stages over the course of two years. You may feel nauseous when receiving chemotherapy, but some medications may help you avoid vomiting.

Chemotherapy with a stem cell transplant 

Big doses of chemotherapy could be needed for certain people with B-cell ALL. 

However, doctors are hesitant to send big doses since it can damage the bone marrow. A stem cell transplant will assist in this situation. Following your high-dose chemo, you'll get a stem cell transplant to help your bone marrow function normally again.

A transplanted stem cell lives in the bone marrow and aids in the production of fresh blood cells. The fresh stem cells will be provided by a donor when you get this transplant. To avoid the body rejecting the fresh cells, you'll need to join a waiting list to select a donor that is a perfect fit for you. The greatest hope for a successful match is with close relatives, such as a brother or sister. If it doesn't fit, you'll need to get on a list of strangers who may be willing to donate. Perhaps the only option for you to have the correct stem cells comes from others of your own race or ethnicity.

You will be administered high doses of chemo for a week or two before the transplant. This may be a difficult procedure because you may have fatigue and mouth sores.

You'll begin the transplant once the high dose chemo is complete. An IV is used to administer the fresh stem cells. This will not be very painful, and you'll be conscious when it happens.

It may take 2 to 6 weeks for the stem cells to replicate and begin producing fresh blood cells after the transplant. During this process, you could be in the hospital or may continue to return to the hospital’s transplant team every day to be tested. It will take up from 6 months to a year for the body's regular blood cell count to return to normal.

Targeted therapy

Drugs are used in this procedure to target specific sections of cancer cells. The medications used in this method of treatment are usually taken every day in pill form. They are less likely to have serious adverse effects than chemotherapy. While this therapy does not succeed for all, it does send many patients into remission and can help prevent the cancer from returning.

CAR T-cell therapy

It's a form of gene therapy licenced by the FDA for children and adults with B-cell ALL who haven't responded to other therapies.

CAR T-cell therapy treats tumours by using more of your own immune cells, known as T cells. Doctors take the blood cells and alter them by inserting different genes. The latest T-cells also improved their ability to detect and destroy cancer cells.

Taking Care of Yourself

You must ensure you do what you can to work with your doctor to help manage your side effects during treatment. 

Since chemotherapy may cause stomach upset, you might want to consider modifying some of your dietary habits. Avoid foods that are fried or spicy, for example. Instead of the usual three meals, start taking five to six small meals during the day to help with digestion and nausea.

Take short naps throughout the day if treatment makes you fatigued. Some patients notice more energy in going for short walks daily. 

Deep relaxation, yoga, meditation and journaling are some methods patients find that help with stress and anxiety during treatment. 

Engage with family and friends who can provide moral support as needed. Your doctor can also recommend local support groups in your area that can journey with you.

What to Expect

It's possible that your B-cell ALL treatment program could take several years. Following the treatment, you'll see your doctor on a regular basis to ensure that the cancer hasn't returned. Your doctor will also monitor for any treatment-related side effects.

Treatment can induce remission and prevent recurrence for some patients. Others could have cancer that does not go away entirely or returns. If that's the case, you may require chemotherapy or other medications on a routine basis to keep it under control for as long as possible.

It's likely that B-cell ALL treatment would stop functioning. If this occurs, you might want to concentrate on palliative treatment, and make sure you're as comfortable as possible. You do not have power over your disease, but you do have influence over how you live your life.

You don't have to go through this on your own. Consider attending a support group so you can talk about your experience and worries with others who care.

Getting Support

More information about support groups can be found at National Cancer Society Malaysia https://cancer.org.my/get-help/support-groups/

Source:

Referenced on  27/4/2021 

  1. American Cancer Society: “Leukemia — Acute Lymphocytic."
  2. Bethematch.org: “Acute lymphoblastic leukemia (ALL)."
  3. Cleveland Clinic: “Adult Acute Lymphoblastic Leukemia."
  4. Medscape: “Acute Lymphoblastic Leukemia."
  5. National Cancer Institute: “B-cell acute lymphoblastic leukemia," “General Information About Adult Acute Lymphoblastic Leukemia," “Adult Acute Lymphoblastic Leukemia Treatment (PDQ®)," “Managing Chemotherapy Side Effects."
  6. Cancer Care.org: “Understanding and Managing Chemotherapy Side Effects."
  7. https://www.webmd.com/cancer/lymphoma/b-cell-acute-lymphoblastic-leukemia-adults#1

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