Doctors have long recognized that children with Down syndrome are significantly more susceptible to leukemia, and have believed that they also were at higher risk of treatment-related chronic conditions. Now, new research led by UCSF Benioff Children’s Hospital San Francisco, with data from the Childhood Cancer Survivor Study, challenges this belief and offers fresh insights into survivorship.
In their investigation, researchers found that, among survivors of childhood leukemia, those with Down syndrome had treatment-related chronic conditions at generally the same rate as survivors without the genetic disorder.
They did find that those with Down syndrome had an increased risk of severe or multiple conditions, including cataracts, hearing loss and thyroid dysfunction. However, when the researchers looked at the onset of these conditions, they determined that they appeared to be less likely related to leukemia treatment, and more likely related to the natural consequences of Down syndrome.
They also found that those in the study with Down syndrome had a significantly decreased risk of second cancers related to their leukemia treatment.
The findings were published in the journal Cancer on Nov. 3, 2017.
The researchers, led by Robert Goldsby, MD, of UCSF Benioff Children’s Hospital San Francisco, tracked the outcomes of 154 pediatric leukemia survivors with Down syndrome, a disorder caused by an extra copy of chromosome 21. They compared them with 581 non-Down syndrome survivors, matched by age at diagnosis, race, gender and treatment. Both groups had a minimum of five years’ survivorship. Approximately two-thirds of survivors had been diagnosed with leukemia between the ages of 1 and 4, and the majority were aged between 10 and 29 at the time of last follow-up.
The study participants had been diagnosed with acute lymphoblastic leukemia (ALL), the most common pediatric cancer, or acute myeloid leukemia (AML), which together make up about 30 percent of all childhood cancers.