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Precursor B-Cell Lymphomas

Precursor B-Cell Lymphoblastic Leukaemia/Lymphoma

  • A precursor B-cell, called a B-cell lymphoblast, is an immature lymphocyte that is eventually destined to become a mature B-cell. It is this cell that becomes cancerous in precursor B-cell lymphoblastic lymphoma.
  • Precursor B-cell lymphoblastic lymphoma is a type of aggressive NHL that occurs mainly in children and adolescents, with two-thirds being male. A second peak of occurrence happens later in life in people over 40 years of age.

Lymphoblastic cancers are classified as either lymphoblastic leukaemias (called acute lymphoblastic leukaemia [ALL]) or lymphoblastic lymphomas. Both are cancers of immature lymphocytes with the major differences illustrated in the following table:

Lymphoblastic Leukaemia & Lymphoma 

 
Lymphoblastic Leukaemia Lymphoblastic Lymphoma
Type of lymphocyte most commonly affected B-cells T-cells
Where the cancer is located Bloodstream Lymph Nodes

 

  • The majority of precursor B-cell cancers are leukaemias, which are far more common than precursor B-cell lymphomas.

What are the symptoms?

Common symptoms include pallor (paleness of skin), fatigue, bleeding, fever and infections.
When a blood test is performed and blood cells are counted, red blood cells and platelets are usually lower than normal, while white blood cells may be low, normal or high in the bloodstream (although they are abnormal in the bone marrow). 

At the time of diagnosis other sites outside of the lymph nodes may also be affected and may cause symptoms such as swollen lymph nodes, enlarged liver or spleen, neurological disturbances, enlargement of testicles in men or skin involvement.

The diagnosis is usually made by bone marrow biopsy. This usually shows high numbers of cancerous B-cell lymphoblasts.

How is it treated?

The treatment of precursor B-cell lymphoblastic leukaemia/lymphoma involves combination chemotherapy - using several different types of chemotherapy drugs in the one treatment. The overall cure rate in children is 85%, while about 50% of adults remain disease-free for long periods of time. In people whose disease is confined to lymph nodes, a high cure rate is often possible.