T-Cell ALL


I'm not an oncologist, but this is what Spencer has - T-cell Acute Lymphoblastic Leukemia. Lymphoblastic leukemia is the most common type of childhood leukemia. Myleogenous leukemia is the other type and is more common in adults, but is less treatable. There are basically two main types of lymphoblastic leukemia - T-cell and B-cell. 85% of the cases are B-cell, 15% T-cell. Stanford claims to get about 5 cases of T-cell per year, with perhaps 250 cases total per year in the US. It is more common amongst adolescent males, say in the pre-teen and early-teen years. But it does occur in females and younger children.

B and T refer two the two types of white blood cells that are in the body. The T cells are the "attacker cells" that attack invading cells in the body. Regardless of the type, leukemia cells are abnormal white blood cells that for some reason do not completely develop. They become what are known as "blasts". They can reproduce themselves uncontrollably and to no end and that is what causes the white blood count to go way up. T-cell is the more aggressive type of leukemia, meaning among other things, that the t-cells tend to reproduce themselves more rapidly (see spencer's white counts around diagnosis).

Historically B-cell has had a better prognosis than T-cell, partly because both types used to be lumped together and treated the same. Perhaps only in the past 10 years or so have T-cell patients been treated separately. Unfortunately B-cell gets most of the research dollars because it is so common, so less is known about T-cell. However, recent results have raised the results of T-cell treatment dramatically. This has not come without a price, however. T-cell protocols are very aggressive and nearly always contain radiation. It is very hard on the patient as the chemo is very frequent and in high doses.

One of the most frustrating things about leukemia is no one knows what causes it. There are some known increased risks such as exposure to radiation (think Hiroshima) and benzene. But there is no conclusive evidence about why normal people get it. Theory is that all people are born with or produce abnormal cells, but only through some exceedingly complex series of events do some of these cells become leukemic cells. What events these are are anyone's guess. We did participate in a huge study that is almost complete that is a very extensive examination of the activities and backgrounds of leukemia patients and their families. Many questions focused on the mother and her family history. You don't get it from sitting on dirty toilet seats or standing in front of the microwave. Leukemia rates have been on the rise in recent years and it is more common in developed countries and in the middle classes or above. One thing is known for sure about it - it sucks.