{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T15:36:25Z","timestamp":1781796985565,"version":"3.54.5"},"reference-count":14,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,10,27]]},"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:p>Concordant leukaemia in identical twins is rare. The likelihood of concordance of leukaemia in twins is near 100% in infancy, around 10% from 1 to 6 years of age, and rare at a later age with variable latency. Reporting of new cases of concordant leukaemia in twins is encouraged to contribute to data pool of this infrequent but exceptional condition; especially when the theories with respect to evolution, natural history and molecular evidence explaining concordant leukaemia in identical twins are still evolving.<\/jats:p>\n               <jats:p>We discuss identical pair of monochorionic twin toddlers who were detected to have pallor and blood investigations revealed pancytopenia. Further work up including bone marrow studies revealed synchronous diagnosis of B-acute lymphoblastic leukaemia (B-ALL) with <jats:italic>ETV6::RUNX1<\/jats:italic> fusion. Synchronous presentation of concordant leukaemia in identical twins is extremely rare. Index twins are the only second set of twins and first one beyond infantile age with synchronous presentation of B-ALL.<\/jats:p>","DOI":"10.1136\/bcr-2023-257139","type":"journal-article","created":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T13:00:36Z","timestamp":1700053236000},"page":"e257139","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Synchronous presentation of <i>ETV6::RUNX1<\/i> fusion positive concordant B-acute lymphoblastic leukaemia in identical twin toddlers"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4754-8340","authenticated-orcid":false,"given":"Sanjeev","family":"Khera","sequence":"first","affiliation":[{"name":"Pediatrics, Army Hospital Research and Referral, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun","family":"Kurup","sequence":"additional","affiliation":[{"name":"Pediatrics, Military Hospital Patiala, Patiala, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Pathology, Army Hospital Research & Referral, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Preeti","family":"Tripathi","sequence":"additional","affiliation":[{"name":"Pathology, Army Hospital Research & Referral, New Delhi, Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,11,15]]},"reference":[{"key":"2025082707505803000_16.11.e257139.1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2002-12-3817"},{"key":"2025082707505803000_16.11.e257139.2","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1017\/S112096230002504X","article-title":"Leukemia in twins: world-wide review of clinical cases","volume":"19","author":"Keith","year":"1970","journal-title":"Acta Genet Med Gemellol (Roma)"},{"key":"2025082707505803000_16.11.e257139.3","first-page":"533","article-title":"Zur Kenntniss der Leukamie und Pseudoleukamie Im Kindesalter","volume":"35","author":"Senator","year":"1882","journal-title":"Berliner Kli_nische Wochenschrift"},{"key":"2025082707505803000_16.11.e257139.4","first-page":"228","article-title":"Genetic aspects of leukemia","volume":"6","author":"Zuelzer","year":"1969","journal-title":"Semin Hematol"},{"key":"2025082707505803000_16.11.e257139.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199502163320701"},{"key":"2025082707505803000_16.11.e257139.6","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1999.01777.x"},{"key":"2025082707505803000_16.11.e257139.7","unstructured":"The placenta in twin pregnancy By S . Bound volume with jacket. XVI-134 pages. Acta Genet Medicae Gemellol Twin Res 1967:412."},{"key":"2025082707505803000_16.11.e257139.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(62)80014-6"},{"key":"2025082707505803000_16.11.e257139.9","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/S0140-6736(71)92705-X","article-title":"Possible explanation of the high Concoddance for acute leukaemia in Monozygotic twins","volume":"297","author":"Clarkson","year":"1971","journal-title":"The Lancet"},{"key":"2025082707505803000_16.11.e257139.10","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-199805000-00015"},{"key":"2025082707505803000_16.11.e257139.11","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1038\/s41568-018-0015-6","article-title":"A causal mechanism for childhood acute Lymphoblastic leukaemia","volume":"18","author":"Greaves","year":"2018","journal-title":"Nat Rev Cancer"},{"key":"2025082707505803000_16.11.e257139.12","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-10-251413"},{"key":"2025082707505803000_16.11.e257139.13","doi-asserted-by":"publisher","DOI":"10.1182\/blood.v85.12.3662.bloodjournal85123662"},{"key":"2025082707505803000_16.11.e257139.14","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1038\/s41375-022-01756-1","article-title":"Covert pre-Leukaemic clones in healthy Co-twins of patients with childhood acute Lymphoblastic leukaemia","volume":"37","author":"Ford","year":"2023","journal-title":"Leukemia"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-257139","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:51:05Z","timestamp":1756306265000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-257139"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11]]},"references-count":14,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11,15]]},"published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1136\/bcr-2023-257139"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-257139","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11]]}}}