Understanding T-Lymphoblastic Lymphoma/Leukemia
- The parents of Josh Asbury believe if he was not admitted to the hospital for Covid, doctors would not have discovered his rare cancer.
- The main difference between lymphocytic leukemias and lymphomas is that in leukemia, the cancer cells are mainly in the bone marrow and blood, while in lymphoma they tend to be in lymph nodes and other tissues.
- In the case of T-lymphoblastic lymphoma/leukemia, this cancer can either be considered a lymphoma or a type of acute lymphoblastic leukemia, depending on how much of the bone marrow is involved.
"We won't ever know for sure if it was Covid that sped up his diagnosis," Andy Asbury, Josh's father, tells The Mirror, "but some people are saying in a way Covid saved his life."
Read MoreJosh's Cancer Diagnosis
The youngster began suffering from fatigue and lack of appetite after he contracted Covid-19 in September. His doctor told Andy and his wife Heather that what Josh was experiencing was likely from the virus, so he was sent home. However, the 9-year-old began complaining of a back ache under his left shoulder blade. His parents rushed Josh back to the doctor, which is where air pockets in his lungs were discovered. He was then sent for a body scan, but his health began to deteriorate rapidly and he was rushed to the hospital the same hospital where he was struggling to breathe because of Covid.
At the hospital, doctors discovered Josh had a collapsed lung, and while they were operating, they discovered a growth. It was sent for tests, which revealed that the 9-year-old had a rare cancer called T-lymphoblastic lymphoma/leukemia; doctors immediately started Josh on an aggressive chemotherapy regimen.
"I was just extremely shocked," Andy says. "It's hard to explain as a parent when you are told your son might have cancer. … It was a massive shock for everybody, even the doctors."
The mass on Josh's chest that doctors discovered was "quite big," Andy says, adding that it was about 12 centimeters. "It doesn't sound big but when it is on your chest and on your airway, it is quite some size."
On Nov. 20, Josh started treatment with chemotherapy, a treatment that is expected to last for the next three and a half years. Luckily, it seems that Josh is responding well to the treatment; Andy reports that the mass has shrunk to about 50% of what it was prior.
"But in 12 weeks we have gone from having a very fit and healthy boy who would normally be playing football every weekend to one who is very tired and fatigued," Andy adds.
Understanding This Rare Cancer
According to the American Cancer Society, the main difference between lymphocytic leukemias and lymphomas is that in leukemia, the cancer cells are mainly in the bone marrow and blood, while in lymphoma they tend to be in lymph nodes and other tissues.
In the case of T-lymphoblastic lymphoma/leukemia, this cancer can either be considered a lymphoma or a type of acute lymphoblastic leukemia, or ALL, depending on how much of the bone marrow is involved. (This is a rare cancer; it accounts for about 1% of all lymphomas, according to ACS. It is most common in teens or young adults, with males being affected more often than females.)
It is unclear if Josh's cancer is considered lymphoma or a type of ALL.
What Kind of Lymphoma Do You Have? Why Your Type Matters
In the case of lymphoma, SurvivorNet expert Dr. Elise Chong, medical oncologist at Penn Medicine, says she always advises that "people understand their specific type of lymphoma, because there are over 40 different types."
"One of the best ways to wrap your head around lymphoma is to start thinking about the different ways we categorize lymphoma," she says, adding that the first differentiator is whether you have Hodgkin or non-Hodgkin lymphoma.
Hodgkin lymphoma has distinctive, giant cells called Reed-Sternberg cells. The presence of these cells, which can be seen under a microscope, will help your doctor determine which of the two lymphoma types you have. There are a few other important differences to note, the main one being that non-Hodgkin lymphoma is much more common.
The next question your doctor will want to answer is whether your cancer is affecting your B-cells or T-cells. That answer is important because it will help to determine which treatment you get.
Most non-Hodgkin lymphomas about 85% affect B-cells. However, T-cell lymphomas are much more rare; these cancers make up just 15% of non-Hodgkin lymphomas. Unlike B-cells, T-cells directly destroy bacteria and other invaders. Rare cancer T-lymphoblastic lymphoma/leukemia is a type of T-cell lymphoma cancer (as long as there is not much bone marrow involvement, then the cancer would be considered a type of ALL.)
T-cell lymphoma cancer often starts in the thymus (a small organ behind the breastbone and in front of the heart, which is where many T cells are made), and can grow into a large tumor in the mediastinum (the area between the lungs), according to ACS. This can cause trouble breathing and swelling in the arms and face trouble breathing is a symptom Josh exhibited prior to his diagnosis.
The chance of curing this type of cancer with chemotherapy is "quite good," according to ACS. Often, the lymphoma form of this disease is treated in the same way as the leukemia form.
Contributing: SurvivorNet staff
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