title: Co-Incidence or Co-Existence? Acute Lymphoblastic Leukaemia in HbE-alpha Thalassaemia: A Case Report with Review of Literature.
abstract: Haemoglobin E (HbE) is a Haemoglobin variant that commonly occurs in many places in Asia. As β thalassaemia and α thalassaemia also occur in the same regions, the co-inheritance of these conditions leads to various phenotypic forms. HbE α thalassaemia is less common and of a milder phenotype than HbE β thalassaemia. Though malignancies are one of the complications in thalassaemia, occurrence of leukaemia is a rare event. Here we present a case of a two-year-old male child co-presenting with pre B acute lymphoblastic leukaemia (ALL) with MLL rearrangement and HbE alpha thalassaemia. The child is on remission 12 months post-therapy with standard ALL high risk protocol with no minimal residual disease (MRD). Haematological and oncological conditions coexisting at presentation is a challenge to therapy. This case is described for its rarity. Informed consent has been obtained from the parents.
authors.affiliation: Postgraduate Student, Department of Pathology, Sri Ramachandra Medical College & Research Institute , Porur, Chennai, India .
authors.forename: Rithika
authors.initials: R
authors.lastname: Rajendran
authors.affiliation: Professor, Department of Pathology, Sri Ramachandra Medical College & Research Institute , Porur, Chennai, India .
authors.forename: Febe Renjitha
authors.initials: FR
authors.lastname: Suman
authors.affiliation: Assistant Professor, Department of Paediatric Hematology Oncology, Sri Ramachandra Medical College & Research Institute , Porur, Chennai, India .
authors.forename: Aruna
authors.initials: A
authors.lastname: Rajendran
authors.affiliation: Professor, Department of Paediatric Hematology Oncology, Sri Ramachandra Medical College & Research Institute , Porur, Chennai, India .
authors.forename: Julius Xavier
authors.initials: JX
authors.lastname: Scott
keywords: Haemoglobin variants; Paediatric leukaemia; Thalassaemic syndrome