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Down's syndrome and acute leukemia in children: an analysis of phenotype by
use of monoclonal antibodies and electron microscopic platelet peroxidase
reaction [see comments]
S Kojima, T Matsuyama, T Sato, K Horibe, S Konishi, M Tsuchida, Y Hayashi, H Kigasawa, Y Akiyama and J Okamura
Division of Hematology/Oncology, Children's Medical Center, Japanese Red
Cross Nagoya First Hospital, Japan.
The clinical, hematologic, and immunophenotypic features in 20 patients
with Down's syndrome (DS) and acute leukemia were analyzed. Of the 20
patients, all 14 patients who were 3 years old and less were diagnosed as
having acute megakaryoblastic leukemia (AMKL) by use of platelet- specific
monoclonal antibodies and platelet peroxidase (PPO) reaction in electron
microscopy. They were characterized by the presence of bone marrow
fibrosis, having a history of myelodysplastic syndrome (MDS) and a poor
response to chemotherapy. Only one patient has remained in continuous
complete remission for more than 1 year. Acute leukemia in six patients who
were older than 4 years was classified as common acute lymphoblastic
leukemia antigen (CALLA)-positive acute lymphoblastic leukemia (ALL). In
one of six patients classified as ALL, the leukemic blasts simultaneously
expressed myeloid-associated surface antigens. All six patients achieved a
complete remission and have remained in continuous complete remission and
have remained in continuous complete remission from 10 to 52 months from
the initial diagnosis. Although it has been suggested that the distribution
of types of acute leukemia in patients with DS is similar to that in normal
children, the present study shows that the distribution of acute leukemia
types is quite different from that in patients without Down's syndrome.
Volume 76,
Issue 11,
pp. 2348-2353,
12/01/1990
Copyright © 1990 by The American Society of Hematology
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