title: Acute leukaemia in children with Down syndrome: a population-based Nordic study.
abstract: To determine the epidemiology and outcome of children with Down syndrome (DS) diagnosed with acute leukaemia in the Nordic countries, data registered in the Nordic Society of Paediatric Haematology and Oncology (NOPHO) population-based leukaemia registry were analysed. Of 3494 children with acute leukaemia diagnosed between July 1984 and December 2001, 136 patients (3.9%) with DS were identified. 2.1% of the children with acute lymphoid leukaemia (ALL) and 14.0% of the children with acute myeloid leukaemia (AML) had DS. In ALL, DS patients had similar age and sex distribution and no major differences in blood counts compared with non-DS children. None of the DS patients had T cell leukaemia. Outcome was inferior to that of non-DS children and treatment results did not improve over time. In AML, DS patients showed a significant female predominance and all but one were <5 years old. DS patients with AML had significantly lower platelet and white blood cell counts and two-thirds were type M7 as according to the French-American-British classification. None of the patients <5 years of age had typical AML cytogenetic aberrations. Outcome was far better in the DS group. DS patients treated for AML after 1992 had an excellent outcome (probability of event-free survival, 83 +/- 6%). The high proportion of female DS patients with AML is unexplained. The differing treatment results in AML versus ALL need further evaluation and represent a challenge for the coming years.
authors.affiliation: Department of Paediatrics, National Hospital of Norway, N-0027 Oslo, Norway. bem.zeller@rikshospitalet.no
authors.forename: Bernward
authors.initials: B
authors.lastname: Zeller
authors.forename: Göran
authors.initials: G
authors.lastname: Gustafsson
authors.forename: Erik
authors.initials: E
authors.lastname: Forestier
authors.forename: Jonas
authors.initials: J
authors.lastname: Abrahamsson
authors.forename: Niels
authors.initials: N
authors.lastname: Clausen
authors.forename: Jesper
authors.initials: J
authors.lastname: Heldrup
authors.forename: Liisa
authors.initials: L
authors.lastname: Hovi
authors.forename: Gudmundur
authors.initials: G
authors.lastname: Jonmundsson
authors.forename: Sverre O
authors.initials: SO
authors.lastname: Lie
authors.forename: Anders
authors.initials: A
authors.lastname: Glomstein
authors.forename: Henrik
authors.initials: H
authors.lastname: Hasle
mesh_terms: D000208:Acute Disease; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D004314:Down Syndrome / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007951:Leukemia, Myeloid / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D008297:Male; D009664:Norway / Q000453:epidemiology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000453:epidemiology / Q000628:therapy