![]() Direct evidence of a genetic heritable predisposition to ALL due to certain genetic syndromes, such as Bloom syndrome, neurofibromatosis, ataxia-telangiectasia and trisomy 21 is only found in a small percentage of ALL cases (<5%). Most cases of ALL in children are sporadic, and ALL is not considered an inherited disease. Both are in full remission at present, 6 and 10 years after diagnosis, respectively. ![]() The 2 siblings were treated according to the PETHEMA BR protocol and responded well to chemotherapy. The father had insulin-dependent diabetes mellitus since age 25 years, the mother was healthy, and a paternal aunt had died of cancer at age 40 years. The relevant family history included an older brother aged 6 years with B-cell precursor ALL diagnosed 4 years earlier that had completed treatment 2 years after the diagnosis. A bone marrow sample was obtained 48 h after admission whose analysis revealed infiltration with 60% of blast cells and markers compatible with common ALL (B-cell precursor). The complete blood count revealed pancytopenia. There were no other medical or surgical diseases. The boy had received vaccinations conforming to the official schedule. There had been no complications during pregnancy, delivery or the neonatal period. The patient was a boy aged 18 months brought to the emergency department with fever of up to 39 ° C lasting 2 days and associated with cold symptoms and breathing difficulties. We present a case of ALL in a sibling of a patient that had received a diagnosis of ALL 4 years earlier. 1 In recent years, genetic mutations associated with an increased risk of ALL have been reported, in spite of which its heritability remains uncertain. This statement is based on the following: (1) there is a strong association between ALL and some chromosomal translocations (2) the incidence of acute leukaemia is greater in relatives of patients with acute leukaemia, and (3) there is a higher incidence of leukaemia in individuals with certain genetic syndromes (Down syndrome, Klinefelter syndrome, neurofibromatosis, Shwachman syndrome, etc.). There is growing evidence of the role of genetic factors in its aetiology. ![]() 1 Its underlying mechanisms are largely unknown. Acute lymphoblastic leukaemia (ALL) is the most frequent childhood cancer and accounts for 80% of cases of acute leukaemia.
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