title: Myelosuppression and infectious complications in children with Down syndrome and acute lymphoblastic leukemia.
abstract: Children with Down syndrome (DS) bear an increased risk of acute lymphoblastic leukemia (ALL) and treatment complications. We compared blood counts and toxicities in 22 DS and 44 non-DS ALL patients. Patients with DS had deeper, longer neutrophil and monocyte count nadirs; more toxicities (HR 2.0, P = 0.0005); longer hospitalizations (HR 1.4, P < 0.0001); and more frequent microbiologically documented infections (HR 5.7, P = 0.0019), mucositis (HR 29.0, P = 0.0006), and cellulitis (HR 3.0, P = 0.033). Severe neutropenia, monocytopenia, and increased cellulitis in DS-ALL suggest the importance of skin hygiene, vigilance and aggressive treatment of cutaneous infections.
authors: Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030, USA. krrabin@txch.org
authors: Karen R
authors: KR
authors: Rabin
authors: Justin
authors: J
authors: Smith
authors: Claudia A
authors: CA
authors: Kozinetz
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D002481:Cellulitis / Q000097:blood / Q000139:chemically induced / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D004314:Down Syndrome / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D008297:Male; D009503:Neutropenia / Q000097:blood / Q000139:chemically induced / Q000517:prevention & control; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000150:complications / Q000188:drug therapy*