For ALL, staging is not done on the basis of tumor size because it begins from bone marrow. Normally, ALL spreads to other parts of the body prior to its detection and staging procedure will count other factors in addition to spread for staging.
Different stages of acute lymphocytic leukemia include:
- Untreated ALL
- ALL in remission. This means there’s no sign of leukemia after treatment
- Minimal residual disease. This stage refers to presence of minute count of leukemia cells in bone marrow
- Refractory ALL. During this stage the patient fails to respond to therapy
- Recurrent ALL or Relapsed ALL refers to come back of the disease post treatment
B-cell ALL staging
B-lymphocytes or B cells are produced in the bone marrow, where they also mature. B-cells play a large role in humoral immune response and serve the principal functions of making antibodies against antigens and developing into memory B cells after they have been activated by antigen interaction.
T-cell ALL staging
T-lymphocytes or T cells are a specific type of leukemia which is similar to some types of lymphoma. These cells are aggressive and progress quickly. Also, these leave the bone marrow before maturation and move to the thymus, where they mature.
There are several different subsets of T cells that have distinct functions this includes Helper, Cytotoxic, Memory, Regulatory, Natural killer and Gamma Delta T cells.
B vs. T cells
Acute lymphoblastic leukemia (ALL) is a blood cancer which affects the lymphocytic cells, a type of white blood cell. People with ALL produce too many immature lymphoid cells, also called as blast cells which populate the blood and bone marrow, thereby, preventing it from producing healthy blood cells.
The WHO system divides ALL into several groups, which includes B-cells and T-cells. While B lymphocytes, or B cells, are a type of white blood cells that play a crucial role in protecting your body from infection by making antibodies against antigens, T-cells, on the other hand are vital in hosting an immune response against pathogens.
Similar treatment protocols are used for both B-ALL and T-ALL.