Acute leukemia in children with Down syndrome

Down syndrome or constitutional trisomy 21(OMIN#190685) was linked to leukemia for the firsttime in a case report published in 1930.1 Since then, Down syndrome has been recognized as one of the most important leukemia-predisposing syndromes and patients with Down syndrome and leukemia have unique clinical fea-tures and significant differences in treatment response and toxicity profiles compared to patients without Down syn-drome. One of the challenges faced in treating children with Down syndrome and leukemia is balancing curative therapy against potential toxicities. As first reported by the Pediatric Oncology Group (POG) and later confirmed by several other cooperative treatment groups, Down syndrome children with acute myeloid leukemia (AML), and in particular the acute megakaryocytic leukemia (AMkL) subtype, have exceptional-ly high cure rates. In this group of patients, the reported