Alpha thalassemia major--a hematological prelude to an oncological problem

Alpha thalassemia major and choriocarcinoma are two poles apart clinical entities. While the former represents an autosomal recessive disorder of hemoglobin synthesis, the later constitutes an aggressive malignant tumor usually of placental origin with predilection for women above 35 years, and those with history of hydatidiform mole and previous spontaneous abortion. Surprisingly, these two entities share strikingly similar geographic distribution. Although dietary deficiency esp of carotene and animal fat, and difference in methodology of study has been blamed for high occurrence of choriocarcinoma in Asia region, a very plausible explanation may be the high rate of spontaneous abortion in this region secondary to high incidence of alpha thalassemia major. While it is worthwhile investigating the factors that increases the risk of choriocarcinoma on account of its high prevalence in Southeast Asia, understanding the influential role of alpha thalassemia in its strikingly higher occurrence will definitely aid in further reducing its incidence to a minimum.