1
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AlAhmari FS, Alageel AF, Aldosari MA, Bagha MY. The quality of life of parents of children with down syndrome in a tertiary care hospital: A qualitative research study at Saudi Arabia. Ann Med Surg (Lond) 2022; 81:104428. [PMID: 36147136 PMCID: PMC9486666 DOI: 10.1016/j.amsu.2022.104428] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/07/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022] Open
Abstract
Background As children with down syndrome (DS) usually have significant morbidities, they can also represent a significant burden on their caregivers and impact their quality of life (QoL). We conducted this study to investigate whether or not having DS children can impact the different domains of the QoL of their caregivers in Saudi Arabia. Methods This is a cross-sectional phenomenological qualitative research study that was conducted in a tertiary care hospital, Riyadh, Saudi Arabia. To assess the study outcomes, we used the WHOQOL-BREF to assess the different domains of the QoL. Results We have included 261 caregivers to DS children that responded to our questionnaire. The mean (SD) scores for the WHOQOL-BREF domains were 84 (±15), 88 (±15), 41 (±10), and 105 (±24), including the physical, psychological, social relations, and environmental domains, respectively. There was a significant difference between all of the scores that have been reported for these domains (P-value <0.001). Furthermore, educational level and the number of children were significantly associated with the psychological and physical domains, while the number of children was the only significant variable with the social relation. Finally, educational level, number of children, and average monthly income were all significantly correlated with the environmental domain. Conclusion Our study indicates that the QoL of caregivers to DS children is significantly impacted in the different domains, indicating the urgent need to apply adequate interventions. Down syndrome is well-known for its less-than-optimal quality of life. The importance of caregivers and their roles in caring for down syndrome is important and is often overlooked. Studying and reporting the quality of life of the caregivers of Down syndrome patients is often missed and must be explored.
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2
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Triarico S, Trombatore G, Capozza MA, Romano A, Mastrangelo S, Attinà G, Maurizi P, Ruggiero A. Hematological disorders in children with Down syndrome. Expert Rev Hematol 2022; 15:127-135. [PMID: 35184659 DOI: 10.1080/17474086.2022.2044780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Silvia Triarico
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | | | | | - Alberto Romano
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - Stefano Mastrangelo
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - Giorgio Attinà
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - Palma Maurizi
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00168 Rome, Italy
| | - Antonio Ruggiero
- Pediatric Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, 00168 Rome, Italy
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3
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Prentice D, Deiter R, Stanley J. Death of a Fetus With Myeloproliferative Disorder and Trisomy 21. ACTA ACUST UNITED AC 2020; 119:208-211. [PMID: 30801117 DOI: 10.7556/jaoa.2019.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A 27-year-old woman, gravida 2, para 1, presented at 24 weeks gestation with an intrauterine death. She previously consulted with maternal-fetal medicine because of a high suspicion of trisomy 21 after abnormal maternal serum screen and cell-free DNA test results. The patient elected to have chromosomal analysis following the death of the fetus, which confirmed a trisomy 21 diagnosis. Placental pathologic findings suggested that the cause of fetal death was total occlusion of the major vessels due to the accumulation of myeloid precursor cells, a novel mechanism. This case report discusses the rare finding of myeloproliferative disorder as a cause of death of a fetus with trisomy 21.
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Le Grignou M, Bleriot A, Nizon M, Pacquement H, Houdayer C, Thebaud E, Le Meur G, Isidor B. Bilateral retinoblastoma due to a germline mutation of RB1 in a child with down syndrome. Ophthalmic Genet 2019; 40:86. [PMID: 30822236 DOI: 10.1080/13816810.2019.1582070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Alice Bleriot
- a Service d'Ophtalmologie, Hôtel Dieu , Nantes , France
| | - Mathilde Nizon
- b Service de Génétique Médicale, Hôtel Dieu , Nantes , France
| | | | - Claude Houdayer
- d Service de Génétique, INSERM U830 , Institut Curie , Paris , France
| | - Estelle Thebaud
- e Service d'Oncologie Pédiatrique, HOPITAL MERE ET ENFANT , Nantes , France
| | | | - Bertrand Isidor
- b Service de Génétique Médicale, Hôtel Dieu , Nantes , France
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Yazar A, Yorulmaz A, Türe E, Akın F, Sert A. Down Sendromlu hastalarda subklinik hipotiroidizm ve hematolojik parametreler arasındaki ilişki. FAMILY PRACTICE AND PALLIATIVE CARE 2018. [DOI: 10.22391/fppc.422181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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6
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Martínez-Macías FJ, Bobadilla-Morales L, González-Cruz J, Quiles-Corona M, Corona-Rivera A, Peña-Padilla C, Orozco-Vela M, Silva-Cruz R, Velarde-Rivera F, Corona-Rivera JR. Descriptive study of the complete blood count in newborn infants with Down syndrome. Am J Med Genet A 2017; 173:897-904. [DOI: 10.1002/ajmg.a.38097] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 11/28/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Francisco Javier Martínez-Macías
- Department of Molecular Biology and Genomics; Dr. Enrique Corona-Rivera Institute of Human Genetics; University of Guadalajara; Health Sciences University Center; Guadalajara Jalisco México
| | - Lucina Bobadilla-Morales
- Department of Molecular Biology and Genomics; Dr. Enrique Corona-Rivera Institute of Human Genetics; University of Guadalajara; Health Sciences University Center; Guadalajara Jalisco México
- Center for Registry and Research in Congenital Anomalies (CRIAC); Pediatrics Division; Service of Genetics and Cytogenetics Unit; Dr. Juan I. Menchaca Civil Hospital of Guadalajara; Guadalajara Jalisco México
| | - Janet González-Cruz
- Pediatrics Division; Service of Neonatology; Dr. Juan I. Menchaca Civil Hospital of Guadalajara; Guadalajara Jalisco México
| | - Moisés Quiles-Corona
- Pediatrics Division; Service of Neonatology; Dr. Juan I. Menchaca Civil Hospital of Guadalajara; Guadalajara Jalisco México
| | - Alfredo Corona-Rivera
- Department of Molecular Biology and Genomics; Dr. Enrique Corona-Rivera Institute of Human Genetics; University of Guadalajara; Health Sciences University Center; Guadalajara Jalisco México
- Center for Registry and Research in Congenital Anomalies (CRIAC); Pediatrics Division; Service of Genetics and Cytogenetics Unit; Dr. Juan I. Menchaca Civil Hospital of Guadalajara; Guadalajara Jalisco México
| | - Christian Peña-Padilla
- Center for Registry and Research in Congenital Anomalies (CRIAC); Pediatrics Division; Service of Genetics and Cytogenetics Unit; Dr. Juan I. Menchaca Civil Hospital of Guadalajara; Guadalajara Jalisco México
| | - Mireya Orozco-Vela
- Department of Molecular Biology and Genomics; Dr. Enrique Corona-Rivera Institute of Human Genetics; University of Guadalajara; Health Sciences University Center; Guadalajara Jalisco México
| | - Rocío Silva-Cruz
- Department of Molecular Biology and Genomics; Dr. Enrique Corona-Rivera Institute of Human Genetics; University of Guadalajara; Health Sciences University Center; Guadalajara Jalisco México
| | - Fernando Velarde-Rivera
- Central Laboratory; Dr. Juan I. Menchaca Civil Hospital of Guadalajara; Guadalajara Jalisco México
| | - Jorge Román Corona-Rivera
- Department of Molecular Biology and Genomics; Dr. Enrique Corona-Rivera Institute of Human Genetics; University of Guadalajara; Health Sciences University Center; Guadalajara Jalisco México
- Center for Registry and Research in Congenital Anomalies (CRIAC); Pediatrics Division; Service of Genetics and Cytogenetics Unit; Dr. Juan I. Menchaca Civil Hospital of Guadalajara; Guadalajara Jalisco México
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7
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Santoro SL, Martin LJ, Hopkin RJ. Screening for Hematological Disorders in Mosaic Down Syndrome: Parent Report of Experiences. Clin Pediatr (Phila) 2016; 55:421-7. [PMID: 26084538 DOI: 10.1177/0009922815589911] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Children with Down syndrome (DS) have increased risk for multiple medical conditions with published health care guidelines. Current guidelines do not specify whether or not they apply to mosaic DS (mDS). We surveyed families of patients with mDS regarding screening, including monitoring practices as well as complications identified. Hematological complications were similar to those reported in nonmosaic DS. Of 91 parents of children with mDS surveyed, only 69% had ever had a screening lab; only 57% had ever had a screening complete blood count (CBC). Younger children were less likely to be screened (for CBC, 50% of 0- to 3-year-olds vs 90% of 4- to 12-year-olds; P = 0.0036). Screening practices are suboptimal, with the youngest children at greatest risk. Comparing reported screening practices with physician adherence, there was discrepancy between perceptions of adherence and perceptions of practice. Children with mDS should be monitored on the same schedule as other children with DS.
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Affiliation(s)
- Stephanie L Santoro
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA Nationwide Children's Hospital Medical Center, Columbus, OH, USA
| | - Lisa J Martin
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Robert J Hopkin
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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8
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King ME, Hueckel R. Transient myeloproliferative disease: keeping a high index of suspicion. J Pediatr Oncol Nurs 2013; 29:289-93. [PMID: 22907684 DOI: 10.1177/1043454212452340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Transient myeloproliferative disorder (TMD) can be found in well or ill newborns with Down syndrome. Although it is a relatively harmless process for most, in some children, TMD can present as a life-threatening state requiring critical care. As the disease is seemingly uncommon, some providers may lack a sense of urgency in the dissemination of TMD awareness; however, one can never know on whose door this patient may knock tomorrow. Advanced practice professionals should be prepared for the TMD patient that may present without warning. The goals of this article are to discuss common presentations, diagnosis, and management; and to bring attention to this often de-emphasized disease.
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9
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Biron-Shental T, Kitay-Cohen Y, Tene T, Sharony R, Amiel A. Increased TERC gene copy number in amniocytes from fetuses with trisomy 18 or a sex chromosome aneuploidy. Gene 2012; 506:46-9. [DOI: 10.1016/j.gene.2012.06.072] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 06/19/2012] [Accepted: 06/21/2012] [Indexed: 11/15/2022]
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10
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Groß B, Pittermann E, Reinhardt D, Cantz T, Klusmann JH. Prospects and challenges of reprogrammed cells in hematology and oncology. Pediatr Hematol Oncol 2012; 29:507-28. [PMID: 22857266 DOI: 10.3109/08880018.2012.708707] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Induced pluripotent stem cells (iPSCs) have emerged as a promising basis for modeling pediatric genetic disorders, allowing the derivation, study, and genetic correction of disease and patient-specific cell lines in vitro. Similar to embryonic stem cells (ESCs), iPSCs are capable of unlimited in vitro expansion and derivation of many cell types, including hematopoietic stem cells (HSCs). These may not only allow large scale screenings to develop therapeutic compounds, but also help to overcome cross-species barriers of genetically engineered animal models, which do not adequately recapitulate the associated human phenotype. Here, we review the current state and emerging developments of iPSC research, which can be exploited as a tool in modeling pediatric hematopoietic disorders and could lead to new clinical applications in gene and cell therapies.
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Affiliation(s)
- Benjamin Groß
- Department of Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
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11
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Abstract
These guidelines are designed to assist the pediatrician in caring for the child in whom a diagnosis of Down syndrome has been confirmed by chromosome analysis. Although a pediatrician's initial contact with the child is usually during infancy, occasionally the pregnant woman who has been given a prenatal diagnosis of Down syndrome will be referred for review of the condition and the genetic counseling provided. Therefore, this report offers guidance for this situation as well.
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12
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Sukenik-Halevy R, Biron-Shental T, Sharony R, Fejgin MD, Amiel A. Telomeres in trisomy 21 amniocytes. Cytogenet Genome Res 2011; 135:12-8. [PMID: 21734364 DOI: 10.1159/000329714] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2011] [Indexed: 12/23/2022] Open
Abstract
Individuals with trisomy 21 have an increased risk of developing leukemia and premature dementia. They also have a higher rate of telomere loss. The aim of the study was to compare telomere length and the hTERC gene copy number, which encodes the telomerase RNA subunit, in amniocytes of trisomy 21 conceptions and normal pregnancies. A quantitative fluorescence-in-situ protocol (Q-FISH) was used to compare telomere length in amniocytes cultured from 11 trisomy 21 conceptions and from 14 normal pregnancies. Quantification was conducted using novel computer software. Fluorescence in situ hybridization (FISH) was used to assess the percentage of cells with additional copies of hTERC. We found that the immunofluorescence intensity, which represents telomere length, was significantly lower in amniocytes from trisomy 21 conceptions compared to the control group. The trisomy 21 group had a higher number of cells with additional copies of hTERC. This observation could be one of the cytogenetic parameters that represent a state of genetic instability and might play a role in the pathomechanism of typical features of Down syndrome, such as dementia and malignancy.
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Affiliation(s)
- R Sukenik-Halevy
- Genetics Institute, Meir Medical Center, Kfar Saba, Israel. riki.sukenik @ gmail.com
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13
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Dixon NE, Crissman BG, Smith PB, Zimmerman SA, Worley G, Kishnani PS. Prevalence of iron deficiency in children with Down syndrome. J Pediatr 2010; 157:967-971.e1. [PMID: 20650467 PMCID: PMC2988945 DOI: 10.1016/j.jpeds.2010.06.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Revised: 04/16/2010] [Accepted: 06/08/2010] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To determine the prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) in a sample of children with Down syndrome (DS) and to evaluate the effect of macrocytosis on the diagnosis of ID/IDA in these children. STUDY DESIGN Children with DS ≥ 12 months of age who were followed at the Duke University Medical Center Comprehensive DS Clinic from December 2004 to March 2007 were screened for ID/IDA with a complete blood count, reticulocyte count, iron panel, and erythrocytic protoporphyrins. RESULTS A total of 114 children were enrolled, with a median age of 4.7 years. ID was identified in 12 subjects (10%), and IDA was identified in 3 subjects (3%). ID/IDA would not have been accurately diagnosed in 13 of 15 subjects (86%) if red blood cell (RBC) indices alone had been used for screening. Abnormal RBC indices with low transferrin saturation were 100% sensitive for ID/ IDA screening. CONCLUSIONS Prevalence of ID/IDA in children with DS was comparable with that in the general pediatric population. Macrocytosis had implications for screening of ID/IDA with only RBC indices. We suggest ID/IDA screening in DS children be done with a laboratory panel at least including complete blood count, reticulocyte count, transferrin saturation, and serum ferritin.
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Affiliation(s)
- Natalia E Dixon
- Department of Pediatrics, Hematology-Oncology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
| | - Blythe G Crissman
- Department of Pediatrics, Medical Genetics, Duke University Medical Center, Durham, North Carolina, United States
| | - P Brian Smith
- Department of Pediatrics, Duke University Medical Center, Durham, North Carolina, United States
| | - Sherri A Zimmerman
- Department of Pediatrics, Hematology-Oncology, Duke University Medical Center, Durham, North Carolina, United States
| | - Gordon Worley
- Department of Pediatrics, Program in Neurodevelopmental Dissabilities, Duke University Medical Center, Durham, North Carolina, United States
| | - Priya S Kishnani
- Department of Pediatrics, Medical Genetics, Duke University Medical Center, Durham, North Carolina, United States
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Abstract
The 8p11 myeloproliferative syndrome is an aggressive neoplasm associated with chromosomal translocations involving the fibroblast growth factor receptor 1 tyrosine kinase gene on chromosome 8p11-12. By our count, 65 cases are currently reported in the literature. This neoplasm affects patients of all ages, with a slight male predominance. Patients often present with peripheral blood eosinophilia without basophilia. Bone marrow examination commonly is hypercellular, with or without eosinophilia, which usually leads to the initial diagnosis of a myeloproliferative neoplasm. Many patients also present with or develop lymphadenopathy. Lymph node biopsy in these patients has commonly shown lymphoblastic leukemia/lymphoma, most often reported as being of T-cell lineage, but bilineal myeloid/T-cell lymphomas and less often a myeloid sarcoma are also reported. The natural history of this neoplasm is to evolve into acute leukemia, usually of myeloid or mixed lineage, and less frequently of T- or B-lymphoid lineage. The prognosis is poor despite aggressive chemotherapy, with a few patients achieving long clinical remission after stem cell transplantation. At the molecular level, all cases carry a chromosomal abnormality involving the fibroblast growth factor receptor 1 (FGFR1) gene at chromosome 8p11, where 10 translocations and 1 insertion have been identified. These abnormalities disrupt the FGFR1 and various partner genes, and result in the creation of novel fusion genes and chimeric proteins. The latter include the N-terminal portion of the partner genes and the C-terminal portion of FGFR1. The most common partner is ZNF198 on chromosome 13q12. In the current World Health Organization classification, the 8p11 myeloproliferative syndrome is designated as "myeloid and lymphoid neoplasms with FGFR1 abnormalities."
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Tigay JH. A comparison of acute lymphoblastic leukemia in Down syndrome and non-Down syndrome children: the role of trisomy 21. J Pediatr Oncol Nurs 2010; 26:362-8. [PMID: 20032297 DOI: 10.1177/1043454209340321] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Down syndrome (DS), which occurs once in every 800 births, is associated with a trisomy on locus 21. Among the many aberrations caused by DS, including shortened stature and distorted facies, are several blood dyscrasias, including childhood leukemias-namely, acute myeloid leukemia (AML) and acute lymphoblastic, or lymphocytic, leukemia (ALL). One focus of the diagnosis of ALL is to distinguish it from AML.The benefits of immunophenotyping extend to treatment as well. ALL is associated with an inherited trisomy 21 in DS children (ALL-DS) and with acquired trisomies, +21, 8, and 13, in non-DS children (ALL-NDS). The differences in treatment, outcome, and prognosis between ALL-DS and ALL-NDS can be attributed to the interaction of their respective trisomies with several genetic mutations, including one on the GATA1 growth factor transcription gene. Other mutations are the gene fusion at TEL/AML1, and a new mutation found, which labels the Janus Kinase gene or JAK2 as on oncogenic precursor, which when associated with the B-cell precursor gene or BCP is highly leukomogenic. The treatments for the 2 groups have been based on quality of risk, with ALL-DS children having the highest risk along with the poorest prognosis, but alterations in medication regimens have brought treatment outcomes to near equality. It is worthwhile to study the trisomy 21 because in the future it may provide an understanding of all blood dyscrasias.
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16
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Hadi E, Sharony R, Goldberg-Bittman L, Biron-Shental T, Fejgin M, Amiel A. Telomere aggregates in trisomy 21 amniocytes. ACTA ACUST UNITED AC 2009; 195:23-6. [PMID: 19837264 DOI: 10.1016/j.cancergencyto.2009.03.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2009] [Revised: 03/09/2009] [Accepted: 03/10/2009] [Indexed: 10/20/2022]
Abstract
Trisomy 21 is the most common chromosomal abnormality among persons with intellectual disability, with a live birth rate of 1 in 800-1,000. As such, this abnormality may serve as a model for human disorders that result from supernumerary copies of a genomic region. Down syndrome carries an increased risk of developing acute leukemia and other malignancies. Telomeres of tumor cells nuclei tend to form aggregates (TA). This study evaluated TA formation in amniocytes from trisomy 21 pregnancies, compared with amniocytes from normal euploid pregnancies. A commercially available peptide nucleic acid telomere kit was used to evaluate TA formation, using two-dimensional fluorescence microscopy. Significantly higher frequencies of TA were found in trisomy 21 amniocytes than in amniocytes from normal pregnancies. The TAs found in trisomy 21 amniocytes apparently represent an additional parameter that reflects the high genetic instability of this syndrome and its recognized predisposition to develop leukemia and other malignancies.
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Affiliation(s)
- Efrat Hadi
- Department of Obstetrics and Gynecology, Meir Hospital, Kfar Saba, Israel
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17
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Abstract
The use of eponyms has long been contentious, but many remain in common use, as discussed elsewhere (Editorial: Oral Diseases. 2009: 15; 185). The use of eponyms in Diseases of the head and neck is mainly in specialties dealing with medically compromised individuals (paediatric dentistry, special care dentistry, oral and maxillofacial medicine, oral and maxillofacial pathology, oral and maxillofacial radiology and oral and maxillofacial surgery) and particularly by hospital-centred practitioners. This series has selected some of the more recognized relevant eponymous conditions and presents them alphabetically. The information is based largely on data available from MEDLINE and a number of internet websites as noted below: the authors would welcome any corrections. This paper summarizes data about Down syndrome.
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Affiliation(s)
- C Scully
- University College London, London, UK.
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18
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Cassimos D, Bezirgiannidou Z, Pantelidou D, Christoforidis A, Chatzimichael A, Maritinis G. Warm autoimmune hemolytic anemia following recurrent mycoplasma pneumonia infections in a child with Down syndrome. Pediatr Hematol Oncol 2008; 25:693-8. [PMID: 18850483 DOI: 10.1080/08880010802237492] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Mycoplasma pneumonia (MP) is mainly associated with cold agglutinin syndrome, whereas both cold IgM and warm IgG autoantibodies have been identified in only two cases in the literature. The authors present an 8-year-old boy with Down syndrome, who suffered from recurrent episodes of MP infection, followed by episodes of hemolytic anemia with normal titer of cold agglutinins. The first 6 episodes were sequenced by nonimmune hemolytic anemia, whereas the latter 7 episodes were followed by episodes of warm autoimmune hemolytic anemia. This is believed to be the first described case of hemolytic anemia with warm IgG autoantibodies, following MP infection.
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Affiliation(s)
- Dimitris Cassimos
- Pediatric Department, General University Hospital of Alexandroupoli, Alexandroupolis, Greece
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Treatment and prognostic impact of transient leukemia in neonates with Down syndrome. Blood 2008; 111:2991-8. [PMID: 18182574 DOI: 10.1182/blood-2007-10-118810] [Citation(s) in RCA: 162] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Approximately 10% of the neonates with Down syndrome (DS) exhibit a unique transient leukemia (TL). Though TL resolves spontaneously in most patients, early death and development of myeloid leukemia (ML-DS) may occur. Prognostic factors as well as treatment indication are currently uncertain. To resolve that issue, we prospectively collected clinical, biologic, and treatment data of 146 patients with TL. The 5-year overall survival (OS) and event-free survival (EFS) were 85% plus or minus 3% and 63% plus or minus 4%, respectively. Multivariate analysis revealed a correlation between high white blood cell (WBC) count, ascites, preterm delivery, bleeding diatheses, failure of spontaneous remission, and the occurrence of early death. Treatment with cytarabine (0.5-1.5 mg/kg) was administered to 28 patients with high WBC count, thrombocytopenia, or liver dysfunction. The therapy had a beneficial effect on the outcome of those children with risk factors for early death (5-year EFS, 52% +/- 12% vs 28% +/- 11% [no treatment]; P = .02). Multivariate analysis demonstrated its favorable prognostic impact. A total of 29 (23%) patients with TL subsequently developed ML-DS. Patients with ML-DS with a history of TL had a significantly better 5-year EFS (91% +/- 5%) than those without documented TL (70% +/- 4%), primarily due to a lower relapse rate. A history of TL may therefore define a lower-risk ML-DS subgroup. This study was registered at www.clinicaltrials.gov as no. NCT 00111345.
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Ha JS, Lee WM, Kim JH, Ryoo NH, Jeon DS, Kim JR, Kim HS, Choi BK. GATA1Mutation in Transient Myeloproliferative Disorder of Down Syndrome. THE KOREAN JOURNAL OF HEMATOLOGY 2008. [DOI: 10.5045/kjh.2008.43.1.43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Jung Sook Ha
- Department of Laboratory Medicine, School of Medicine, Keimyung University, Deagu, Korea
| | - Won Mok Lee
- Department of Laboratory Medicine, School of Medicine, Keimyung University, Deagu, Korea
| | - Ji Hye Kim
- Department of Laboratory Medicine, School of Medicine, Keimyung University, Deagu, Korea
| | - Nam Hee Ryoo
- Department of Laboratory Medicine, School of Medicine, Keimyung University, Deagu, Korea
| | - Dong Suk Jeon
- Department of Laboratory Medicine, School of Medicine, Keimyung University, Deagu, Korea
| | - Jae Ryong Kim
- Department of Laboratory Medicine, School of Medicine, Keimyung University, Deagu, Korea
| | - Heung Sik Kim
- Department of Pediatrics, School of Medicine, Keimyung University, Deagu, Korea
| | - Byung Kyu Choi
- Department of Pediatrics, School of Medicine, Keimyung University, Deagu, Korea
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Moriuchi R, Shibaki A, Yasukawa K, Onozuka T, Sato T, Kaneda M, Iguchi A, Kobayashi R, Shimizu H. Neonatal vesiculopustular eruption of the face: a sign of trisomy 21-associated transient myeloproliferative disorder. Br J Dermatol 2007; 156:1373-4. [PMID: 17459046 DOI: 10.1111/j.1365-2133.2007.07877.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Henry E, Walker D, Wiedmeier SE, Christensen RD. Hematological abnormalities during the first week of life among neonates with Down syndrome: Data from a multihospital healthcare system. Am J Med Genet A 2007; 143A:42-50. [PMID: 17163522 DOI: 10.1002/ajmg.a.31442] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Various hematological abnormalities have been reported among neonates with Down syndrome. Thrombocytosis, thrombocytopenia, polycythemia, neutrophilia, transient myeloproliferative disorder (TMD), and congenital leukemia have all been reported. The two largest case series previously reported involved 63 and 31 cases. To acquire hematological data from a larger case series, we obtained all CBCs done during the first week after birth on all neonates with Down syndrome cared for in an Intermountain Healthcare (IHC) hospital with a date of birth between January 1, 2001 and December 31, 2005. During this period, 145,522 live births were recorded at 18 hospitals. Down syndrome was recognized in 226 (1 in 644). One hundred fifty-eight (70%) of these had one or more CBCs obtained before the seventh day (144 hr). Neonates who did versus did not have a CBC in the first week had a similar gestational age, birth weight, percentage who were LGA and SGA, and length of stay. Neutrophilia was the most common hematological abnormality detected, with 80% of absolute neutrophil counts above the upper limit of normal for age. Six percent (9/158) had blasts identified on the blood film and three, where this was persistent, were referred to the pediatric hematology service for further evaluation. The next most commonly detected abnormality was thrombocytopenia, with 66% of platelet counts <150,000/microl, and with 6% of counts <50,000/microl. The mean platelet volume did not correlate with the platelet count, but tended to run slightly large (9.2 +/- 1.3 fl), with 24% of values above 10 fl. Only one had a platelet transfusion. Polycythemia was the next most common hematological abnormality detected, with 33% of hematocrit values above 65% or hemoglobin concentrations above 22 g/dl. Six had a reduction transfusion. One patient had significant anemia (hematocrit <15%) and received an erythrocyte transfusion. One had neutropenia associated with an infection after bowel surgery. Neutrophilia, thrombocytopenia, and polycythemia were the most common hematological abnormalities observed among neonates with Down syndrome. Anemia, thrombocytosis, and neutropenia were not more common than among neonates who do not have Down syndrome. Hematological abnormalities were so common in this group that it seems reasonable to recommend that one or more CBCs be obtained on all neonates with Down syndrome.
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Affiliation(s)
- E Henry
- Department of Women and Newborns, Intermountain Healthcare, Institute for Health Care Delivery Research, University of Utah School of Medicine, Salt Lake City, Utah, USA
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