What Is B-Cell Acute Lymphoblastic Leukemia (B-cell ALL)?

What are the possible causes of B-cell ALL?

The underlying cause of B-cell acute lymphoblastic leukemia (B-cell ALL) is still unclear in the majority of cases. However, in children with B-cell ALL, chromosomal abnormalities include changes in the number and translocations of the chromosomes that result in a rearrangement of the genes.

Possible causes of B-cell ALL may include:

• If patients have received chemotherapy or radiation medication for cancer in the past, their risk of B-cell ALL is higher.
• Additionally, receiving chemotherapy and radiation at the same time may also increase the risk of B-cell ALL.
• Research suggests that factors such as lifestyle, genetic disorders or chromosome abnormalities may play a role in developing B-cell ALL.
• Pesticides, magnetic exposure and overstimulation of the immune response during the first years of life are thought to be related to an increase in the occurrence of B-cell ALL.
• Moreover, children with Down syndrome and other genetic disorders are more likely to develop B-cell ALL.

What are the treatment options for B-cell ALL?

The ideal outcome of treatment for patients with B-cell acute lymphoblastic leukemia (B-cell ALL) is to achieve a complete remission with chemotherapy, followed by a bone marrow transplant or maintenance treatment, whichever is the best for them.

Chemotherapy is a common treatment used to either kill the cancerous B-cells or stop them from dividing. It is commonly used in induction therapy but can also be used as consolidation and maintenance therapies.

Different treatment phases of B-cell ALL may include:

Induction therapy:

• This phase aims to kill all or a majority of the cancerous B-cells in the blood and bone marrow to restore normal blood cell production, which has been disrupted by the presence of the cancerous B-cells.

Consolidation therapy:

• In this phase, any remaining leukemia in the body, such as in the brain or spinal cord, is ideally destroyed.

Relapsed or refractory reinduction chemotherapy:

• This is given to patients with relapsed cancer or those who did not respond to induction therapy (refractory).

Preventive therapy for the central nervous system (sometimes called intrathecal chemotherapy):

• During any of the treatment phases, additional treatment may be given to kill the cancerous B-cells located in the CNS.
• Chemotherapy drugs are often injected directly into the cerebrospinal fluid (CSF), which is fluid that is present around the spinal cord.

Maintenance therapy:

• This ongoing phase is intended to prevent any cancerous B-cells from multiplying again, with lower doses of therapy often given for years.

Apart from chemotherapy, below are the other B-cell ALL treatment options:

Targeted therapy:

• Targeted therapy is treatment with drugs that attack specific abnormalities present in cancer cells that allow them to grow and thrive.
• These drugs do not simultaneously harm the healthy cells like conventional chemotherapy drugs.
• Targeted therapy may be used during or after chemotherapy.

Stem cell transplantation (SCT):

• This can be used as consolidation therapy in patients who have a high risk of relapse or for treating relapse when it occurs.
• SCT helps patients reestablish a healthy bone marrow.
• Patients receiving SCT are given high doses of chemotherapy or radiation to destroy any cancerous B-cells.
• The blood-forming stem cells are then infused to restore the bone marrow of patients.