Efficacy and safety of reduced-intensity chemotherapy in children with Down syndrome-related myeloid leukemia / 白血病·淋巴瘤

ABSTRACT

Objective:To investigate the efficacy and safety of reduced-intensity chemotherapy in treatment of children with Down syndrome-related myeloid leukemia (ML-DS).Methods:The clinical data of 3 hospitalized children with ML-DS who were diagnosed and treated by Children Oncology Group Trial A2971 chemotherapy regimen in Fujian Medical University Union Hospital from January 2016 to June 2019 were retrospectively analyzed, and the clinical characteristics, efficacy and safety were summarized.Results:The ages of 3 children were 1 year and 6 months, 2 years and 6 months, and 1 year and 10 months. Two cases were acute monocytic leukemia, and 1 case was acute megakaryoblastic leukemia. Two cases were positive for EVI1 gene and 1 case had ASXL1 gene mutation, and all 3 cases had complex karyotype. After one course of induction chemotherapy, all 3 cases achieved complete remission, and the minimal residual disease turned negative. During the induction chemotherapy, all 3 cases had severe myelosuppression, and 2 cases of them suffered from severe pneumonia and 1 case of them suffered from intestinal infection and septic shock.Conclusion:The efficacy of reduced-intensity chemotherapy in children with ML-DS is favorable, but the severe complications such as myelosuppression and infection need to be taken seriously.