Increased A ge a t D iagnosis H as a S ignificantly N egative E ffect on O utcome i n C hildren W ith D own S yndrome a nd A cute Myeloid L eukemia: A R eport F rom t he C hildren's C ancer Group S tudy 2 891

Purpose: To determine the outcome of children with Down syndrome (DS) and acute myeloid leukemia (AML) receiving standard timing chemotherapy without bone marrow transplantation (BMT), with determination of prognostic factors. Patients and Methods: Children with DS and newly diagnosed AML or myelodysplasia were prospectively enrolled on Children’s Cancer Group study 2891 (N 161) and treated uniformly with four standard timing induction courses of dexamethasone, cytarabine arabinoside, 6-thioguanine, etoposide, daunorubicin (DCTER) followed by intensively timed high-dose cytarabine. Results: Children with DS were significantly younger at diagnosis than those without (median age, 1.8 v 7.5 years, respectively; P 2 years; P .002). Conclusion: Outcome for children with DS and AML is excellent with standard induction therapy, but declines with increasing age. J Clin Oncol 21:3415-3422. © 2003 by American Society of Clinical Oncology.