Chapter 8

Update in Hematology and Oncology in Down Syndrome

Mohamed Ramadan El-Shanshory

Abstract

Down syndrome (DS) is commonly associated with hematological and oncologic disorders than non-syndromic children. Interpretation of the blood picture should be done with caution. Polycythemia and iron deficiency anemia (IDA); both are common in those children. Presence of IDA in DS children adds an extra load on them. Occurrence of transient abnormal myelopoiesis (TAM) in DS neonates is due to the effect of trisomy 21 on liver hematopoiesis with megakaryocyte – erythroid progenitor. Down syndrome children have a 500- fold increase in acute myeloblastic leukemia (AMKL) compared to the non-syndromic children. They also have increased risk for development of acute lymphoblastic leukemia (ALL) which affects 1 in 300 children with DS. At the same time; despite the high prevalence of leukemia’s in DS children; the risk for the development of solid tumors is globally unexpected to be low. Several novel therapies will benefit many children with DS and ALL and other malignancies.

Total Pages: 298-312 (15)

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