Clinical characteristics and outcome of refractory/relapsed myeloid leukemia in children with Down syndrome

Takashi Taga, Akiko Moriya Saito, Kazuko Kudo, Daisuke Tomizawa, Kiminori Terui, Hiroshi Moritake, Akitoshi Kinoshita, Shotaro Iwamoto, Hideki Nakayama, Hiroyuki Takahashi, Akio Tawa, Akira Shimada, Tomohiko Taki, Hisato Kigasawa, Katsuyoshi Koh, Souichi Adachi

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Myeloid leukemia in Down syndrome (ML-DS) is associated with good response to chemotherapy and favorable prognosis. Because little research has been focused on refractory/relapsed (R/R) cases, we conducted a retrospective analysis for R/R ML-DS. Among ML-DS patients diagnosed between 2000 and 2010 in Japan, 26 relapsed (25 in the BM and 1 in the skin), and 3 refractory patients were enrolled. The male/female ratio was 18/11. The median age at initial diagnosis of ML-DS was 2 years, and the median time to relapse was 8.6 months. Each patient initially had been treated with ML-DS-specific protocols. Thirteen of the 26 patients achieved complete remission with various kinds of reinduction chemotherapies; 2 of 8 survived without further recurrence after receiving allogeneic hematopoietic stem cell transplantation, and 4 of 5 maintained complete remissions with chemotherapy alone. Treatment failures mostly were associated with disease progression rather than treatment-related toxicities. The 3-year OS rate was 25.9% ± 8.5%. A longer duration from initial diagnosis to relapse was a significant favorable prognostic factor (P <.0001). We conclude that clinical outcome for patients with R/R ML-DS generally are unfavorable, even in those receiving hematopoietic stem cell transplantation. Novel methods to identify poor prognostic factors for ML-DS are necessary.

Original languageEnglish
Pages (from-to)1810-1815
Number of pages6
JournalBlood
Volume120
Issue number9
DOIs
Publication statusPublished - Aug 30 2012
Externally publishedYes

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Myeloid Leukemia
Down Syndrome
Refractory materials
Chemotherapy
Stem cells
Hematopoietic Stem Cell Transplantation
Recurrence
Drug Therapy
Toxicity
Skin
Treatment Failure
Disease Progression
Japan
Research

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

Cite this

Taga, T., Saito, A. M., Kudo, K., Tomizawa, D., Terui, K., Moritake, H., ... Adachi, S. (2012). Clinical characteristics and outcome of refractory/relapsed myeloid leukemia in children with Down syndrome. Blood, 120(9), 1810-1815. https://doi.org/10.1182/blood-2012-03-414755

Clinical characteristics and outcome of refractory/relapsed myeloid leukemia in children with Down syndrome. / Taga, Takashi; Saito, Akiko Moriya; Kudo, Kazuko; Tomizawa, Daisuke; Terui, Kiminori; Moritake, Hiroshi; Kinoshita, Akitoshi; Iwamoto, Shotaro; Nakayama, Hideki; Takahashi, Hiroyuki; Tawa, Akio; Shimada, Akira; Taki, Tomohiko; Kigasawa, Hisato; Koh, Katsuyoshi; Adachi, Souichi.

In: Blood, Vol. 120, No. 9, 30.08.2012, p. 1810-1815.

Research output: Contribution to journalArticle

Taga, T, Saito, AM, Kudo, K, Tomizawa, D, Terui, K, Moritake, H, Kinoshita, A, Iwamoto, S, Nakayama, H, Takahashi, H, Tawa, A, Shimada, A, Taki, T, Kigasawa, H, Koh, K & Adachi, S 2012, 'Clinical characteristics and outcome of refractory/relapsed myeloid leukemia in children with Down syndrome', Blood, vol. 120, no. 9, pp. 1810-1815. https://doi.org/10.1182/blood-2012-03-414755
Taga, Takashi ; Saito, Akiko Moriya ; Kudo, Kazuko ; Tomizawa, Daisuke ; Terui, Kiminori ; Moritake, Hiroshi ; Kinoshita, Akitoshi ; Iwamoto, Shotaro ; Nakayama, Hideki ; Takahashi, Hiroyuki ; Tawa, Akio ; Shimada, Akira ; Taki, Tomohiko ; Kigasawa, Hisato ; Koh, Katsuyoshi ; Adachi, Souichi. / Clinical characteristics and outcome of refractory/relapsed myeloid leukemia in children with Down syndrome. In: Blood. 2012 ; Vol. 120, No. 9. pp. 1810-1815.
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abstract = "Myeloid leukemia in Down syndrome (ML-DS) is associated with good response to chemotherapy and favorable prognosis. Because little research has been focused on refractory/relapsed (R/R) cases, we conducted a retrospective analysis for R/R ML-DS. Among ML-DS patients diagnosed between 2000 and 2010 in Japan, 26 relapsed (25 in the BM and 1 in the skin), and 3 refractory patients were enrolled. The male/female ratio was 18/11. The median age at initial diagnosis of ML-DS was 2 years, and the median time to relapse was 8.6 months. Each patient initially had been treated with ML-DS-specific protocols. Thirteen of the 26 patients achieved complete remission with various kinds of reinduction chemotherapies; 2 of 8 survived without further recurrence after receiving allogeneic hematopoietic stem cell transplantation, and 4 of 5 maintained complete remissions with chemotherapy alone. Treatment failures mostly were associated with disease progression rather than treatment-related toxicities. The 3-year OS rate was 25.9{\%} ± 8.5{\%}. A longer duration from initial diagnosis to relapse was a significant favorable prognostic factor (P <.0001). We conclude that clinical outcome for patients with R/R ML-DS generally are unfavorable, even in those receiving hematopoietic stem cell transplantation. Novel methods to identify poor prognostic factors for ML-DS are necessary.",
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