Correspondence: Acute Lymphoblastic Leukaemia and HbE-alpha Thalassaemia

Sir,

The recent report on “Acute Lymphoblastic Leukaemia and HbE-alpha Thalassaemia” is very interesting [1]. Rajendran et al., presented a case study and mentioned that “though malignancies are one of the complications in thalassaemia, occurrence of leukaemia is a rare event [1]”. The occurrence of both disorders in the same patient is extremely and unusual case report [2]. The interesting concern is the co-existence between two disorders. Some reports mentioned for the common pathogenesis between thalassaemia and leukaemia. For example, Chiewsilp et al., noted that “HLA class I was associated with CML, ANLL and Thal [3]”. Genetically, the rooted cause of the two disorders are totally different, different mutation sites, although both are genetic diseases. Hence, the finding of both diseases in the same patient should be an accidental finding. The remained interesting question is the exact prevalence of co-occurrence of the disease. The incidence of acute lymphoblastic leukaemia in general population might not different from that of thalassaemic patients. Based on the experience from Thailand where thalassaemia is highly endemic, there is still no report on such co-occurrence.

[1]. Rajendran R, Suman FR, Rajendran A, Scott JX, Co-Incidence or Co-Existence? Acute Lymphoblastic Leukaemia in HbE-alpha Thalassaemia: A Case Report with Review of Literature J Clin Diagn Res 2015 9(11):XD01-XD02.  [Google Scholar]

[2]. Sherief LM, Kamal NM, Abdelrahman HM, Hassan BA, Zakaria MM, First report of acute lymphoblastic leukaemia in an Egyptian child with β-thalassaemia major Hemoglobin 2015 39(2):127-29.  [Google Scholar]

[3]. Chiewsilp P, Sujirachato K, Mongkolsuk T, Junpong S, Jootar S, Hathirat P, Preliminary study of HLA-ABCDR antigens in CML, ANLL, thalassaemia and severe aplastic anemia in Thais J Med Assoc Thai 2000 83(Suppl 1):S130-36.  [Google Scholar]