Familial Acute Lymphoblastic Leukaemia

ABSTRACT

Background: Acute lymphoblastic leukaemia (ALL) is known to be the most common malignancy in children. However; the true incidence of familial ALL is not known; coupled with scanty data on familial ALL in the Niger Delta Area of Nigeria. Aim: To present a report of the management two cases of ALL from the same parents; whose sibling also died as a diagnosed case of ALL. Case report The first case was a 30-month female who presented with recurrent febrile illness; repeated blood transfusions and hospitalizations in several private hospitals before being referred to the Department of Paediatrics and Child Health; University of Port Harcourt Teaching Hospital; Port Harcourt. A diagnosis of ALL type 1 was made. She was managed with cyclophosphamide; oncovin; methotrexate and prednisolone (COMP). Induction regimen; antimalarials and transfusion of sedimented red blood cells for severe anaemia were administered. There was remission before the child was lost to follow-up. The second case was a 15-month female sibling of the first case who presented essentially with severe anaemia; generalized weakness; repeated blood transfusions; peripheral lymphadenopathy and a non-tender hepatomegaly. Bone marrow aspiration showed features also suggestive of ALL type 2 variant with over 30abnormal lymphoblastic and leukaemic cell infiltrate. She was subsequently put into remission through an induction regimen of COMP plus intrathecal methotrexate and Hydrocortisone. She however relapsed and died 8 months from the time of presentation. Conclusion: Familial ALL in siblings is reported. The interplay of the associated risk factors of genetic; parental; socio-economic and environmental influences on the incidence of familial leukaemia in this environment is discussed