Hematological malignancies complicating β-thalassemia syndromes: a single center experience

Abstract

TO THE EDITOR: Only few reports have addressed the occurrence of hematological malignancies in patients suffering from β-thalassemia. We herein report two patients with major and intermedia β-thalassemia who were complicated with Hodgkin's lymphoma and chronic myelogenous leukemia (CML) during the course of the disease, respectively. This report indicate that malignancies should be suspected and kept in mind in patients with β-thalassemia syndromes presenting with proposed signs and symptoms including unexplained lymphadenopathy, leukocytosis and splenomegaly. β-thalassemia major is a genetic hemoglobinopathy characterized by point mutations of β-globin chain resulting in accumulation and deposition of unpaired β-globin chains in red blood cell (RBC). This causes severe hemolysis and ineffective hematopoiesis leading to severe anemia [1]. Currently the availability of proper care and appropriate treatment strategies including regular transfusions, allogeneic stem-cell transplantation, inducers of fetal hemoglobin, and precise iron chelation therapy with desferrioxamine (DFO) and/or deferiprone (DFP) have resulted in increased life expectancy and quality of life of the patients suffering from β-thalassemia major [2-4]. This increased life span increases the possibility of occurrence of other diseases such as malignancies. Although, previously malignancies were considered rare in β-thalassemia patients, but currently the number of malignancies reported in thalassemic patients is increasing [5-9]. We herein, report two patients with β-thalassemia major and intermedia who developed Hodgkin's lymphoma and chronic myelogenous leukemia (CML) during the course of the disease.