title: Outcome of transplantation for acute lymphoblastic leukemia in children with Down syndrome.
abstract: We report on 27 patients with Down syndrome (DS) and acute lymphoblastic leukemia (ALL) who received allogeneic hematopoietic cell transplantation (HCT) between 2000 and 2009. Seventy-eight percent of patients received myeloablative conditioning and 52% underwent transplantation in second remission. Disease-free survival (DFS) was 24% at a median of 3 years. Post-transplant leukemic relapse was more frequent than expected for children with DS-ALL (54%) than for non-DS ALL. These data suggest leukemic relapse rather than transplant toxicity is the most important cause of treatment failure. Advancements in leukemia control are especially needed for improvement in HCT outcomes for DS-ALL.
authors.affiliation: The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Johann K
authors.initials: JK
authors.lastname: Hitzler
authors.forename: Wensheng
authors.initials: W
authors.lastname: He
authors.forename: John
authors.initials: J
authors.lastname: Doyle
authors.forename: Mitchell
authors.initials: M
authors.lastname: Cairo
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Camitta
authors.forename: Ka Wah
authors.initials: KW
authors.lastname: Chan
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Diaz Perez
authors.forename: Christopher
authors.initials: C
authors.lastname: Fraser
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Gross
authors.forename: John T
authors.initials: JT
authors.lastname: Horan
authors.forename: Alana A
authors.initials: AA
authors.lastname: Kennedy-Nasser
authors.forename: Carrie
authors.initials: C
authors.lastname: Kitko
authors.forename: Joanne
authors.initials: J
authors.lastname: Kurtzberg
authors.forename: Leslie
authors.initials: L
authors.lastname: Lehmann
authors.forename: Tracey
authors.initials: T
authors.lastname: O'Brien
authors.forename: Michael A
authors.initials: MA
authors.lastname: Pulsipher
authors.forename: Franklin O
authors.initials: FO
authors.lastname: Smith
authors.forename: Mei-Jie
authors.initials: MJ
authors.lastname: Zhang
authors.forename: Mary
authors.initials: M
authors.lastname: Eapen
authors.forename: Paul A
authors.initials: PA
authors.lastname: Carpenter
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use; D018572:Disease-Free Survival; D004314:Down Syndrome / Q000150:complications*; D020022:Genetic Predisposition to Disease; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D053208:Kaplan-Meier Estimate; D019520:Living Donors; D019653:Myeloablative Agonists / Q000009:adverse effects / Q000627:therapeutic use; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000235:genetics / Q000601:surgery*; D012008:Recurrence; D012042:Registries; D012074:Remission Induction; D012189:Retrospective Studies; D016879:Salvage Therapy; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D014916:Whole-Body Irradiation / Q000009:adverse effects
chemical_list: D007166:Immunosuppressive Agents; D019653:Myeloablative Agonists; D016572:Cyclosporine; D016559:Tacrolimus
keywords: Down syndrome; acute lymhoblastic leukemia; hematopoietic stem cell transplantation; pediatric; relapse; trisomy 21