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Precursor T-Cell Lymphomas

Precursor T-Cell Lymphoblastic Leukaemia/Lymphoma

What is it?

  • A precursor T-cell, called a T-cell lymphoblast, is an immature lymphocyte that is eventually destined to become a mature T-cell. It is this cell that becomes cancerous in precursor T-cell lymphoblastic lymphoma.
  • Precursor T-cell lymphoblastic lymphoma is a type of aggressive NHL that occurs mainly in children and adolescents, and more often in males than females. A second peak of occurrence is seen later in life in people over 40 years of age.

Lymphoblastic cancers are classified as either lymphoblastic leukaemias (called acute lymphoblastic leukaemia or 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?

  • The most common symptoms include breathing difficulties and other problems resulting from a large mass in the mediastinal area (the centre area of the upper chest), as well as fluid accumulation around the lungs.
  • This type of NHL can spread to the central nervous system, and neurological symptoms may also be present at diagnosis.
  • The diagnosis is usually made by lymph node biopsy. X-rays, bone marrow biopsy, CT scans and blood tests may also be performed.

How is it treated?

  • Intensive chemotherapy is the most common treatment for older children and young adults with aggressive lymphoblastic lymphoma. Young people with localised disease have an excellent prognosis. Adults with later stage precursor T-cell lymphoblastic lymphoma may have stem-cell transplantation as part of their initial treatment plan.