B-cell Acute Lymphoblastic Leukemia (B-ALL)

About B-ALL

Acute lymphoblastic leukemia (ALL) is a fast-growing type of blood cancer that develops in the bone marrow, where blood cells are made.¹

It causes the body to produce abnormal lymphocytes, a type of white blood cell, that don’t function properly.¹

ALL sometimes spreads to other parts of the body like the lymph nodes, liver, spleen, and central nervous system.²

B-cell ALL (B-ALL) is the most common subtype of ALL.¹

B-ALL starts in immature white blood cells in the bone marrow that would normally develop into B-cell lymphocytes.³
B-cell lymphocytes normally help produce antibodies, but in people with B-ALL, these cells multiply uncontrollably, crowding healthy blood cells and harming the immune system.^4-6

There are two subtypes of B-ALL relating to the Philadelphia Chromosome (Ph):

Ph-positive (Ph+): The presence of a specific genetic fusion (BCR-ABL1) that causes leukemia cells to grow. This genetic fusion not only helps drive the disease to grow but also creates a target for treatment.⁷
Ph-negative (Ph-): Does not have the same specific fusion found in Ph-positive (Ph+) ALL and instead includes a range of different genetic mutations and alterations, which may lead to more varied treatment approaches.⁸

Prevalence

ALL is considered a rare disease by the World Health Organization.⁹

There were ~386K+ cases of ALL globally in 2021.¹⁰

There were ~5.7K cases in the United States in 2021.¹¹

B-ALL is the MOST COMMON pediatric cancer globally.¹²

In the U.S., B-ALL makes up 30% of all childhood cancers.⁶

B-ALL is frequently diagnosed in children and adolescents, with more than

of pediatric ALL cases being B-ALL.^14,15

In adults B-ALL accounts for

of ALL cases.¹⁶

Approximately

of B-ALL cases occur in children.¹⁶

Facts and Figures

The five-year overall survival for ALL is approximately 70%.¹⁰

≤0%

Older adult ALL patients (ages 50+) can have a poorer prognosis, with the five-year overall survival rate for these patients remaining below 25%.¹⁰

>0%

Pediatric ALL has a five-year survival rate over 90%.¹⁷

Adolescents and young adults (AYAs), defined as those aged 15 to 39, account for a significant proportion of ALL cases.^18,19

AYAs often experience poorer outcomes compared to pediatric patients.¹⁹

Signs & Symptoms

The signs and symptoms of B-ALL can resemble those of more common illnesses, which can lead to misdiagnosis, especially in its early stages.²⁰

Common symptoms include:^*,21

Fatigue

Easy bruising or bleeding

Weight loss or loss of appetite

Fever or night sweats

Shortness of breath

Pain in bones or stomach

*If you are experiencing symptoms, please contact your physician or a qualified healthcare provider.

Diagnosis

B-ALL is diagnosed through a combination of tests and exams.²²

In addition to reviewing personal and family health history and conducting a physical exam, a doctor may order the following:¹⁵

Blood tests
These tests measure the number of red blood cells, platelets, and white blood cells. They also measure electrolytes and enzymes to assess how the liver, kidney, and other organs are functioning.²²

Bone marrow aspiration or biopsy
A small sample of the bone marrow and bone tissue are collected and examined under a microscope for abnormal cells.²²

Genetic tests
To help identify abnormal genes or chromosomal changes that may influence prognosis and guide treatment decisions, doctors will complete genetic testing.²²

Treatment

Treatment for B-ALL may include a mix of different types of treatments.²³

Some treatment options include:*

CHEMOTHERAPY

Medication given through an injection in the vein or in pill form to stop the growth of cells.²³

RADIATION THERAPY

Radiation uses high-energy x-rays and other types of radiation to stop growth or kill cancer cells.²³

STEM CELL TRANSPLANT

Stem cells are removed from the patient’s, or a donor’s, blood or bone marrow and given back through infusion.²³

TARGETED THERAPIES

Medicines that can identify, attack, and kill specific types of cells.²⁴

IMMUNOTHERAPIES

Treatment that uses the patient’s own immune system to recognize, attack, and kill specific types of cells.²⁴

*Treatment options can be similar for patients newly diagnosed and those experiencing a relapse in their disease.

Measurable Residual Disease (MRD) in B-ALL

MRD is the presence of detectable leukemic cells that remain within the bone marrow after treatment and is used to measure response to treatment and to guide therapy decisions.^25-27

MRD can be a strong predictor of potential relapse in B-ALL patients.²⁵

Patients who are MRD-negative after induction therapy have significantly better outcomes, including higher relapse-free and overall survival rates.^26,27

Approximately 30%–40% of patients with B-ALL may still have detectable cancer cells in their body, despite achieving complete remission with induction and consolidation chemotherapy.^27,28

This resource is for information purposes only and does not replace the independent judgment or guidance of (your) healthcare providers.

References

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