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DOWN'S SYNDROME: BLOOD DISORDERS / LEUKAEMIA. Key Points.
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(based on conference paper by Professor Judith Chessells at RSM conference.
April 2001)
- Over 60% of neonates polycythaemic - unrelated to congenital heart
disease
- MCV increased at all ages
- Almost unique risk of transient abnormal myelopoesis (TAM) in newborns
(approx 10%)
- Morphologically indistinguishable from megakaryocytic leukaemia
- Usually asymptomatic
- Usually resolves spontaneousely without treatment
- Around 25% with TAM may develop acute myeloid leukaemia (AML)
later in childhood
- Childhood leukaemia 20 times more frequent than in other children.
Risk around 1/100. Both AML and ALL (acute lymphoblastic leukaemia).
AML is usually megakaryoblastic (very rare in other children ).
- Children should be entered in national leukaemia trials and should
usually be treated according to protocol.
- Response to treatment of both AML and ALL is good. 5 year survival
for AML in the UK around 60% ( same as other children). For ALL around
75% (poorer than other children).
- Increased risk of death whilst on intensive therapy both during induction
and further treatment, because of inherent increased susceptibility
to infection. Extreme vigilance and maximum supportive care is necessary
at these times.
- Relapse rate less than for other children- survival difference is
largely due to increased risk of death during treatment
- Peak age at onset of leukaemia is before 4 years. No cases recorded
after age 29. Low risk of other childhood cancers.
© DSMIG 20.12.01
This page is also available as a PDF.
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