To report a case of concordant acute lymphoblastic leukemia in monozygotic twins and review literature on the mechanisms of leukemia development, highlighting its significance in understanding pediatric ALL.
Approach:
Key Findings:
Both twins were diagnosed with acute lymphoblastic leukemia and tested positive for the ETV6::RUNX1 fusion gene, underscoring the genetic predisposition.
The case supports the 'in utero origin' and 'two-hit' hypotheses in pediatric ALL, suggesting environmental and genetic interactions.
Concordant leukemia in monozygotic twins is rare, with approximately 70 cases reported globally, emphasizing the need for further research.
Interpretation:
The findings contribute to understanding the genetic and environmental factors in the development of leukemia in twins.
Limitations:
The study is based on a single case report with a limited sample size, which may not be representative of the broader population.
Long-term outcomes beyond the 2-year follow-up period are not addressed, highlighting the need for future studies to assess durability of remission.
Conclusion:
This case adds to the literature on concordant leukemia in twins and supports existing hypotheses regarding its origins, emphasizing the importance of further research in this area.
