title: Acute lymphoblastic leukemia in patients with Down syndrome with a previous history of acute myeloid leukemia.
abstract: Patients with Down syndrome (DS) are predisposed to acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) in early and later childhood, respectively, but rarely experience both. We herein discuss four patients with DS with ALL and a history of AML who were treated with various chemotherapies, one of whom later received a bone marrow transplantation. Three patients survived and remain in remission. One patient died of fulminant hepatitis during therapy. No common cytogenetic abnormalities in AML and ALL besides constitutional +21 were identified, indicating that the two leukemia types were independent events. However, the underlying pathomechanism of these conditions awaits clarification.
authors.affiliation: Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan.|Department of Pediatrics, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Tomizawa
authors.affiliation: Department of Pediatrics, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Akifumi
authors.initials: A
authors.lastname: Endo
authors.affiliation: Department of Pediatrics, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Michiko
authors.initials: M
authors.lastname: Kajiwara
authors.affiliation: Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Sakaguchi
authors.affiliation: Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan.|Department of Hematology and Oncology, Children's Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
authors.forename: Kimikazu
authors.initials: K
authors.lastname: Matsumoto
authors.affiliation: Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Kaneda
authors.affiliation: Department of Pediatrics, Shiga University of Medical Science, Otsu, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Taga
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004314:Down Syndrome; D005260:Female; D006801:Humans; D007223:Infant; D015470:Leukemia, Myeloid, Acute; D008297:Male; D016609:Neoplasms, Second Primary; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma
keywords: Down syndrome; acute lymphoblastic leukemia; acute myeloid leukemia