Transient abnormal myelopoiesis, myelodysplastic syndrome and acute myeloid leukemia in children with Down syndrome

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Abstract

Myeloid neoplasms associated with Down syndrome (DS) are represented by transient abnormal myelopoiesis, acute myeloid leukemia (AML) and myelodysplastic syndrome. Transient abnormal myelopoiesis is a clonal myeloproliferative syndrome characterized by an increased number of blast cells in the peripheral blood, morphologically and immunophenotypically most commonly related to megakaryoblasts, and the presence of an acquired mutation in the GATA1 gene. This syndrome occurs in infants up to 6 months of age. Children with DS have an abnormally high risk of developing hematological malignancies. The incidence of AML in these patients is 150–400 times higher than in children without DS. Survival rates and prognosis in children with AML and DS (AML-DS) treated with reduced-intensity chemotherapy are significantly higher than in children without DS: the overall survival ranges from 84% to 90% and the event-free survival is up to 89%. At the same time, standard intensive chemotherapy (with high-dose anthracyclines and intensive timing of induction) is associated in these patients with high toxicity and significant mortality due to infectious complications. Treatment outcomes in patients with AML-DS in Russia do not exceed 66%, which is significantly lower than those achieved by international cancer research groups. There is a need for standardization of therapy for AML-DS in Russia and introduction of a uniform treatment protocol with reduced chemotherapy doses and common standards of supportive care as well as prophylaxis and treatment of infectious complications. The study was approved by the Independent Ethics Committee and the Scientific Council of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of Russia.

About the authors

Z. A. Abashidze

The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

Author for correspondence.
Email: zalina.abashidze@dgoi.ru
ORCID iD: 0000-0002-6314-2132

Zalina A. Abashidze, a hematologist of Hematology/Oncology Isolation Unit at the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Healthcare of the Russian Federation Address:

1 Samory Mashela St., Moscow 117997

Russian Federation

I. I. Kalinina

The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0002-0813-5626

Moscow

Russian Federation

L. A. Khachatryan

The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0001-7265-0414

Moscow

Russian Federation

M. S. Vasilieva

The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

Moscow

Russian Federation

M. V. Gaskova

The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0002-3277-9018

Moscow

Russian Federation

E. A. Zerkalenkova

The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0001-9634-5828

Moscow

Russian Federation

A. N. Kazakova

The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0002-1085-4646

Moscow

Russian Federation

Yu. V. Olshanskaya

The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0002-2352-7716

Moscow

Russian Federation

E. V. Mikhailova

The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0002-3450-0498

Moscow

Russian Federation

A. M. Popov

The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0002-0889-6986

Moscow

Russian Federation

K. A. Voronin

The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0001-7578-9657

Moscow

Russian Federation

A. A. Maschan

The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0002-0016-6698

Moscow

Russian Federation

G. A. Novichkova

The Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0002-2322-5734

Moscow

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Copyright (c) 2024 Abashidze Z.A., Kalinina I.I., Khachatryan L.A., Vasilieva M.S., Gaskova M.V., Zerkalenkova E.A., Kazakova A.N., Olshanskaya Y.V., Mikhailova E.V., Popov A.M., Voronin K.A., Maschan A.A., Novichkova G.A.

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