Dataset Information

Infections in children with down syndrome and acute myeloid leukemia: a report from the Canadian infections in AML research group.

ABSTRACT: BACKGROUND: Children with Down syndrome (DS) are at high risk of infectious toxicity when treated with acute lymphoblastic leukemia chemotherapy protocols optimized in children without DS. Our objective was to determine if children with DS and acute myeloid leukemia (AML) have a different risk of infection when treated with chemotherapy protocols developed for children with DS compared to AML treatment protocols developed for children without DS. METHODS: We conducted a retrospective, population-based cohort study that included DS children???18 years of age with de novo, non-M3 AML diagnosed between January 1995 and December 2004, and treated at 15 Canadian centers. Patients were monitored for infection from initiation of AML treatment until recovery from the last cycle of chemotherapy, conditioning for hematopoietic stem cell transplantation, relapse, persistent disease or death (whichever occurred first). Trained research associates abstracted all information from each site. RESULTS: There were 31 children with DS included; median age was 1.7 (range 0.1-11.1) years. Eleven were treated according to a DS-specific protocol while 20 were treated with non-DS specific protocols. A total of 157 courses of chemotherapy were delivered. Microbiologically documented sterile site infection occurred in 11.9% and 14.3% of DS-specific and non-DS specific AML treatment courses respectively. Sepsis was rare and there were no infection-related deaths. In multiple regression, treatment with a DS-specific protocol was independently associated with a reduction in microbiologically documented sterile site infection (adjusted odds ratio (OR) 0.65, 95% confidence interval (CI) 0.42-0.99; P?=?0.044), and clinically documented infection (adjusted OR 0.36, 95% CI 0.14-0.91; P?=?0.031) but not bacteremia (adjusted OR 0.73, 95% CI 0.44-1.22; P?=?0.231). CONCLUSIONS: Our study suggests that children with DS do not experience excessive infectious toxicity during treatment for AML compared to children without DS. Incorporation of DS-specific AML treatment protocols is associated with a more favorable infection profile for children with DS-AML.

SUBMITTER: Tran TH

PROVIDER: S-EPMC4174901 | biostudies-other | 2013

REPOSITORIES: biostudies-other

ACCESS DATA

Publications

Infections in children with down syndrome and acute myeloid leukemia: a report from the Canadian infections in AML research group.

Tran Thai Hoa TH Mitchell David D Dix David D Cellot Sonia S Ethier Marie-Chantal MC Gillmeister Biljana B Hitzler Johann J Lewis Victor V Yanofsky Rochelle R Johnston Donna L DL Portwine Carol C Price Victoria V Zelcer Shayna S Silva Mariana M Michon Bruno B Bowes Lynette L Stobart Kent K Brossard Josee J Beyene Joseph J Sung Lillian L

Infectious agents and cancer 20131202 1

<h4>Background</h4>Children with Down syndrome (DS) are at high risk of infectious toxicity when treated with acute lymphoblastic leukemia chemotherapy protocols optimized in children without DS. Our objective was to determine if children with DS and acute myeloid leukemia (AML) have a different risk of infection when treated with chemotherapy protocols developed for children with DS compared to AML treatment protocols developed for children without DS.<h4>Methods</h4>We conducted a retrospectiv ...[more]

PMID: 24289042

Similar Datasets

Project description:Context.—Detailed diagnostic features of acute myeloid leukemia in Down syndrome are lacking, leading to potential misdiagnoses as standard acute myeloid leukemia occurring in patients with Down syndrome.Objective.—To evaluate diagnostic features of acute myeloid leukemia and myelodysplastic syndrome in patients with Down syndrome.Design.—Diagnostic bone marrow samples from 163 patients enrolled in the Children's Oncology Group study AAML0431 were evaluated by using central morphologic review and institutional immunophenotyping. Results were compared to overall survival, event-free survival, GATA1 mutation status, cytogenetics, and minimal residual disease results.Results.—Sixty myelodysplastic syndrome and 103 acute myeloid leukemia samples were reviewed. Both had distinctive features compared to those of patients without Down syndrome. They showed megakaryocytic and erythroid but little myeloid dysplasia, and marked megakaryocytic hyperplasia with unusual megakaryocyte morphology. In acute myeloid leukemia cases, megakaryoblastic differentiation of blasts was most common (54 of 103, 52%); other cases showed erythroblastic (11 of 103, 11%), mixed erythroid/megakaryoblastic (20 of 103, 19%), or no differentiation (10 of 103, 10%). Myelodysplastic syndrome and acute myeloid leukemia cases had similar event-free survival and overall survival. Leukemic subgroups showed interesting, but not statistically significant, trends for survival and minimal residual disease. Cases with institutional diagnoses of French American British M1-5 morphology showed typical features of Down syndrome disease, with survival approaching that of other cases.Conclusions.—Myelodysplastic syndrome and acute myeloid leukemia in Down syndrome display features that allow discrimination from standard cases of disease. These distinctions are important for treatment decisions, and for understanding disease pathogenesis. We propose specific diagnostic criteria for Down syndrome-related subtypes of acute myeloid leukemia and myelodysplastic syndrome.

Dataset Information

Infections in children with down syndrome and acute myeloid leukemia: a report from the Canadian infections in AML research group.

Publications

Infections in children with down syndrome and acute myeloid leukemia: a report from the Canadian infections in AML research group.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets