Children with Down Syndrome May Have Higher Risk of Leukemia

New data from researchers at the University of California (UC) Davis and UC San Francisco suggest that children with Down syndrome may be at increased risk of leukemia.

The large-scale retrospective cohort study, published in The Journal of Pediatrics, evaluated leukemia risk among 3,905,399 children born between 1996 and 2016. Leukemia was diagnosed in 124 of 4,401 children with Down syndrome and 1,941 of 3,900,998 children without Down syndrome, or 2.8% versus 0.05%, respectively.

The cumulative incidence of acute myeloid leukemia (AML) among children with Down syndrome was 1,405 cases per 100,000 people (95% confidence interval [CI] 1,076-1,806) at 4 and 14 years of age. Incidence of acute lymphoid leukemia (ALL) in this population was 1,059 cases per 100,000 people at age 4 (95% CI 755-1,451) and 1,714 cases per 100,000 people at age 14 (95% CI 1,264-2,276). Compared with children without Down syndrome, children with Down syndrome had an increased risk of AML before age 5 (hazard ratio [HR] 399), and greater risk of ALL regardless of age (<5 years, HR 28; ≥5 years, HR 21).

“One main strength of this study is its large cohort with more leukemia cases in children with Down syndrome than most previous studies,” said co-author Emily Marlow, PhD, of the UC Davis Department of Public Health Sciences, via a press release. “This allowed more precise risk estimation, especially for rare leukemia types such as AML-7, previously estimated from small case reports.”

“The good news is that childhood leukemia can be very treatable if caught early,” said co-senior author Diana L. Miglioretti, PhD, professor at UC Davis Department of Public Health Sciences.