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Grane FM. Down syndrome: Parental experiences of a postnatal diagnosis. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:1032-1044. [PMID: 35698902 PMCID: PMC10647884 DOI: 10.1177/17446295221106151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/13/2022] [Indexed: 06/15/2023]
Abstract
Globally it is estimated that Down syndrome occurs in 1 in 800 live births (Bull 2020). It has also been estimated that the incidence of Down syndrome occurs in 1/444 live births in the Republic of Ireland. Given the prevalence of Down syndrome births in Ireland and the fact that care is provided by the majority of parents at home, this qualitative study aimed to explore the experiences of Irish parents receiving a postnatal diagnosis of Down syndrome. A qualitative research approach was used through semi structured interviews. Eight parents of a baby diagnosed postnatally with Down syndrome participated in this study sharing their stories of their postnatal diagnosis experiences. Five overarching themes emerged using a descriptive thematic analysis; 1. prenatal screening, pregnancy and delivery; 2. how the diagnosis was delivered; 3. setting and emotional experiences; 4. moving on with the postnatal diagnosis and 5. Future recommendations from parents' perspectives. This study highlighted the importance of the need for clinicians to ensure that partners are present at the time of the disclosure, that ample time is allocated and that verbal and written communications are provided to parents using less medical jargon when delivering the postnatal diagnosis of Down syndrome. These reasonable adjustments could alleviate parental anxiety at this critical juncture in their lives. Online resources and support forums were also identified as an integral support for families on discharge from the maternity centres and in the early months and years.
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Affiliation(s)
- Fiona Mc Grane
- School of Nursing and Midwifery, Queens University, Belfast, Ireland; Department of Paediatrics, Trinity College, Dublin, Ireland; Department of Neurodisability and Developmental Paediatrics, Children’s Health Ireland at Tallaght, Dublin, Ireland
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2
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Chung J, Krell K, Pless A, Michael C, Torres A, Baker S, Blake JM, Caughman K, Cullen S, Gallagher M, Hoke-Chandler R, Maina J, McLuckie D, O'Neill K, Peña A, Royal D, Slape M, Spinazzi NA, Torres CG, Skotko BG. Healthcare experiences of patients with Down syndrome from primarily Spanish-speaking households. Am J Med Genet A 2023; 191:2132-2141. [PMID: 37338115 PMCID: PMC10524629 DOI: 10.1002/ajmg.a.63250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/28/2023] [Accepted: 05/06/2023] [Indexed: 06/21/2023]
Abstract
We report on the health care experiences of individuals with Down syndrome (DS) from families who are primarily Spanish-speaking. Data were collected through three methods: (1) a nationally distributed, 20-item survey, (2) two focus groups with seven family caregivers of individuals with DS who self-identified as living in primarily Spanish speaking households, and (3) 20 interviews with primary care providers (PCPs) who care for patients who are underrepresented minorities. Standard summary statistics were used to analyze the quantitative survey results. Focus group and interview transcripts, as well as an open-ended response question in the survey, were analyzed using qualitative coding methods to identify key themes. Both caregivers and PCPs described how language barriers make giving and receiving quality care difficult. Caregivers additionally described condescending, discriminatory treatment within the medical system and shared feelings of caregiver stress and social isolation. Challenges to care experienced by families of individuals with DS are compounded for Spanish-speaking families, where the ability to build trust with providers and in the health care system may be compromised by cultural and language differences, systemic issues (lack of time or inability to craft more nuanced schedules so that patients with higher needs are offered more time), mistrust, and sometimes, overt racism. Building this trust is critical to improve access to information, care options, and research opportunities, especially for this community that depends on their clinicians and nonprofit groups as trusted messengers. More study is needed to understand how to better reach out to these communities through primary care clinician networks and nonprofit organizations.
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Affiliation(s)
- Jeanhee Chung
- Laboratory of Computer Science, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kavita Krell
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Albert Pless
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Carie Michael
- Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Amy Torres
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Jasmine M Blake
- Departments of Internal Medicine and Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Sarah Cullen
- Massachusetts Down Syndrome Congress, Burlington, Massachusetts, USA
| | - Maureen Gallagher
- Massachusetts Down Syndrome Congress, Burlington, Massachusetts, USA
| | | | | | | | - Kate O'Neill
- LuMind IDSC Down Syndrome Foundation, Burlington, Massachusetts, USA
| | - Angeles Peña
- Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
| | | | - Michelle Slape
- LuMind IDSC Down Syndrome Foundation, Burlington, Massachusetts, USA
| | - Noemi Alice Spinazzi
- Division of Primary Care, Department of Pediatrics, University of California San Francisco Benioff Children's Hospital Oakland, Oakland, California, USA
| | - Carlos G Torres
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Brian G Skotko
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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Krell K, Pless A, Michael C, Torres A, Chung J, Baker S, Blake JM, Caughman K, Cullen S, Gallagher M, Hoke-Chandler R, Maina J, McLuckie D, O'Neill K, Peña A, Royal D, Slape M, Spinazzi NA, Torres CG, Skotko BG. Healthcare experiences of patients with Down syndrome who are Black, African American, of African descent, or of mixed race. Am J Med Genet A 2023; 191:742-752. [PMID: 36493376 PMCID: PMC9928895 DOI: 10.1002/ajmg.a.63069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/11/2022] [Accepted: 11/18/2022] [Indexed: 12/14/2022]
Abstract
Scant research has explored the healthcare experiences of people with Down syndrome (DS) in the United States who are Black, African American, of African descent, or of mixed race. The purpose of this study was to identify and describe the barriers and facilitators that such patients and their caregivers face when accessing healthcare. We gathered data in three ways: focus groups with caregivers, a national survey completed by caregivers, and in-depth interviews with primary care providers. Many caregivers and primary care physicians felt that patients with DS who are Black, African American, of African descent, or of mixed race receive a lower quality of medical care than their white counterparts with DS. Caregivers mentioned feeling tired of being reminded by the medical community about their race and wanting acknowledgment that raising a child with DS can be hard at times. Many felt that the medical community's conscious and unconscious racial biases do negatively impact the care of their loved ones with DS. Caregivers desired more race concordant medical providers or, when not possible, medical providers who are willing to learn more about DS and build trusted, longitudinal relationships. Primary care providers discussed the need for funded resources and support services to effectively care for their patients with DS.
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Affiliation(s)
- Kavita Krell
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Albert Pless
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Carie Michael
- Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Amy Torres
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jeanhee Chung
- Laboratory of Computer Science, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Jasmine M Blake
- Departments of Internal Medicine and Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Sarah Cullen
- Massachusetts Down Syndrome Congress, Burlington, Massachusetts, USA
| | - Maureen Gallagher
- Massachusetts Down Syndrome Congress, Burlington, Massachusetts, USA
| | | | | | | | - Kate O'Neill
- LuMind IDSC Down Syndrome Foundation, Burlington, Massachusetts, USA
| | - Angeles Peña
- Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA
| | | | - Michelle Slape
- LuMind IDSC Down Syndrome Foundation, Burlington, Massachusetts, USA
| | - Noemi Alice Spinazzi
- Division of Primary Care, Department of Pediatrics, University of California San Francisco Benioff Children's Hospital Oakland, Oakland, California, USA
| | - Carlos G Torres
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Brian G Skotko
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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McLennan JD, Fulford C, Hrycko S, Cobigo V, Tahir M. Service Use Patterns by Children With Down Syndrome in a Canadian Region. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 61:79-88. [PMID: 36706005 DOI: 10.1352/1934-9556-61.1.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 10/17/2022] [Indexed: 05/16/2023]
Abstract
Children with Down syndrome require services from different sectors over time to optimize health and development, however, there is little information on longitudinal, cross-sector service use. Parents of children with Down syndrome attending a Canadian children's hospital participated in semistructured interviews covering life-time multiple sector service use. Five key service patterns were identified: (1) primary care physicians playing a circumscribed role; (2) a marked shift in public habilitative service receipt from development agencies in the preschool years to exclusive school delivery after school entry; (3) families obtaining private services to address gaps from public sector services; (4) a prominent role for parents to identify additional services; and (5) service variability as a function of timing and severity of medical comorbidity.
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Affiliation(s)
- John D McLennan
- John D. McLennan, Department of Psychiatry and Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Casey Fulford
- Casey Fulford, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Sophia Hrycko
- Sophia Hrycko, Children's Hospital of Eastern Ontario & Department of Psychiatry, University of Ottawa, ON, Canada
| | - Virginie Cobigo
- Virginie Cobigo, Children's Hospital of Eastern Ontario & Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Munazza Tahir
- Munazza Tahir, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
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Callans K, Carroll DL, McDonough A. Parental experience of hypoglossal nerve stimulator implantation in adolescents with Down Syndrome and obstructive sleep apnea. J Pediatr Nurs 2023; 68:24-29. [PMID: 36328914 DOI: 10.1016/j.pedn.2022.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/10/2022] [Accepted: 09/01/2022] [Indexed: 01/26/2023]
Abstract
PURPOSE The purpose of this study is to explore the experience of parents in deciding whether to participate in a clinical trial of the insertion of the Hypoglossal Nerve Stimulator (HNS) to treat their adolescent with Down Syndrome (DS) and Obstructive Sleep Apnea (OSA). DESIGN AND METHODS A qualitative descriptive design with interviews was used to gather parental experiences from those who consented to HNS for their adolescent with DS and OSA. Interviews were conducted, audiotaped, and transcribed. Basic content analysis was followed to interpret the data. Using a process of data debriefing/engagement, codes were generated, and field/reflective notes were used to assure trustworthiness of the data. RESULTS Parents, 13 mothers/2 fathers, participated. Three themes were identified: Parents experience desperation about acceptance of standard of care for their adolescent with DS and OSA. This desperation led parents to seek information/insights from social media and they came to rely on those sites to explore options, ultimately leading them to HNS clinical trial. Finally, parents had a desire to share experience with HNS implantation. CONCLUSIONS Parents described being desperate at acceptance of standards of care for OSA. They shifted reliance on experts and parents by searching social media pages to explore options for treatment of OSA. Parents wished to share experiences with the HNS implantation. PRACTICE IMPLICATIONS Nurses play a role in preparing for the HNS by instructing/educating parents. Nurses can identify supportive social media sites for parents during the HNS decision and suggest ways to measure outcomes of HNS.
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Affiliation(s)
- Kevin Callans
- Case Management, Massachusetts Eye and Ear and Massachusetts General Hospital, Boston, MA, United States of America
| | - Diane L Carroll
- Yvonne L. Munn Center for Nursing Research, Massachusetts General Hospital, Boston, MA, United States of America.
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Santoro SL, Howe YJ, Krell K, Skotko BG, Co JPT. Health Surveillance in a Down Syndrome Specialty Clinic: Implementation of EHR-integrations during the COVID pandemic. J Pediatr 2022; 255:58-64.e6. [PMID: 37081778 PMCID: PMC9617631 DOI: 10.1016/j.jpeds.2022.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/13/2022] [Accepted: 10/16/2022] [Indexed: 11/05/2022]
Abstract
Objective To address gaps in routine recommended care for children with Down syndrome, through quality improvement during the COVID-19 pandemic. Study design A retrospective chart review of patients with Down syndrome was conducted. Records of visits to the Massachusetts General Hospital Down Syndrome Program were assessed for adherence to five components of the 2011 American Academy of Pediatrics (AAP) Clinical Report, “Health Supervision for Children with Down Syndrome.” The impact of two major changes was analyzed using statistical process control charts: a planned intervention of integrations to the electronic health record (EHR) for routine health maintenance with age-based logic based on a diagnosis of Down syndrome, created and implemented in July 2020; and a natural disruption in care due to the COVID-19 pandemic, starting in March 2020. Results From December 2018 to March 2022, 433 patients with Down syndrome had 940 visits. During the COVID-19 pandemic, adherence to the audiology component decreased (58% to 45%, p <0.001); composite adherence decreased but later improved. Ophthalmology evaluation remained stable. Improvement in adherence to three components (TSH, hemoglobin, sleep study ever) in July 2020 coincided with EHR-integrations. Total adherence to the 5 AAP guideline components was higher for follow-up visits compared with new patient visits (69% and 61%, respectively; p < 0.01). Conclusion The COVID-19 pandemic influenced adherence to components of the AAP Health supervision for children with Down syndrome but improvements in adherence coincided with implementation of our intervention, and re-opening after the COVID-19 pandemic. As each primary care pediatrician cares for 1–2 patients with Down syndrome (1), for many children the current care model involves a primary care physician providing health supervision for children with Down syndrome following the American Academy of Pediatrics’ (AAP) Clinical Report.(2–4)
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Affiliation(s)
- Stephanie L Santoro
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA.
| | - Yamini J Howe
- Department of Pediatrics, Harvard Medical School, Boston, MA; Lurie Center for Autism, Massachusetts General Hospital, Boston, MA
| | - Kavita Krell
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA
| | - Brian G Skotko
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA
| | - John Patrick T Co
- Department of Pediatrics, Harvard Medical School, Boston, MA; Department of Pediatrics, Massachusetts General Hospital, Boston, MA
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7
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Chung J, Donelan K, Macklin EA, Schwartz A, Elsharkawi I, Torres A, Hsieh YG, Parker H, Lorenz S, Patsiogiannis V, Santoro SL, Wylie M, Clarke L, Estey G, Baker S, Bauer PE, Bull M, Chicoine B, Cullen S, Frey-Vogel A, Gallagher M, Hasan R, Lamb A, Majewski L, Mast J, Riddell T, Sepucha K, Skavlem M, Skotko BG. A randomized controlled trial of an online health tool about Down syndrome. Genet Med 2020; 23:163-173. [PMID: 32879436 DOI: 10.1038/s41436-020-00952-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 12/22/2022] Open
Abstract
PURPOSE We sought to determine if a novel online health tool, called Down Syndrome Clinic to You (DSC2U), could improve adherence to national Down syndrome (DS) guidelines. We also sought to determine if primary care providers (PCPs) and caregivers are satisfied with this personalized online health tool. METHODS In a national, randomized controlled trial of 230 caregivers who had children or dependents with DS without access to a DS specialist, 117 were randomized to receive DSC2U and 113 to receive usual care. The primary outcome was adherence to five health evaluations indicated by national guidelines for DS. DSC2U is completed electronically, in all mobile settings, by caregivers at home. The outputs-personalized checklists-are used during annual wellness visits with the patient's PCP. RESULTS A total of 213 participants completed a 7-month follow-up evaluation. In the intention-to-treat analysis, the intervention group had a 1.6-fold increase in the number of indicated evaluations that were recommended by the primary care provider or completed compared with controls. Both caregivers and PCPs reported high levels of satisfaction with DSC2U. CONCLUSIONS DSC2U improved adherence to the national DS health-care guidelines with a novel modality that was highly valued by both caregivers and PCPs.
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Affiliation(s)
- Jeanhee Chung
- Laboratory of Computer Science, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Karen Donelan
- Department of Medicine, Harvard Medical School, Boston, MA, USA.,Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Eric A Macklin
- Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Alison Schwartz
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Ibrahim Elsharkawi
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Amy Torres
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Yichuan Grace Hsieh
- Laboratory of Computer Science, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Holly Parker
- Laboratory of Computer Science, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Stephen Lorenz
- Laboratory of Computer Science, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Vasiliki Patsiogiannis
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Stephanie L Santoro
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Mark Wylie
- Laboratory of Computer Science, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Lloyd Clarke
- Laboratory of Computer Science, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Greg Estey
- Laboratory of Computer Science, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sandra Baker
- Down Syndrome Association of Los Angeles, Los Angeles, CA, USA
| | | | - Marilyn Bull
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Brian Chicoine
- Advocate Medical Group Adult Down Syndrome Center, Park Ridge, IL, USA
| | - Sarah Cullen
- Massachusetts Down Syndrome Congress, Boston, MA, USA
| | - Ariel Frey-Vogel
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | | | - Reem Hasan
- Department of Internal Medicine and Pediatrics, Oregon Health & Science University, Portland, OR, USA
| | - Ashley Lamb
- Health and Wellness, University of New Hampshire, Durham, NH, USA
| | | | | | - Travis Riddell
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Karen Sepucha
- Health Decision Sciences Center, Massachusetts General Hospital, Boston, MA, USA
| | | | - Brian G Skotko
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA. .,Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
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Sas V, Blag C, Zaharie G, Puscas E, Lisencu C, Andronic-Gorcea N, Pasca S, Petrushev B, Chis I, Marian M, Dima D, Teodorescu P, Iluta S, Zdrenghea M, Berindan-Neagoe I, Popa G, Man S, Colita A, Stefan C, Kojima S, Tomuleasa C. Transient leukemia of Down syndrome. Crit Rev Clin Lab Sci 2019; 56:247-259. [PMID: 31043105 DOI: 10.1080/10408363.2019.1613629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Childhood leukemia is mostly a "developmental accident" during fetal hematopoiesis and may require multiple prenatal and postnatal "hits". The World Health Organization defines transient leukemia of Down syndrome (DS) as increased peripheral blood blasts in neonates with DS and classifies this type of leukemia as a separate entity. Although it was shown that DS predisposes children to myeloid leukemia, neither the nature of the predisposition nor the associated genetic lesions have been defined. Acute myeloid leukemia of DS is a unique disease characterized by a long pre-leukemic, myelodysplastic phase, unusual chromosomal findings and a high cure rate. In the present manuscript, we present a comprehensive review of the literature about clinical and biological findings of transient leukemia of DS (TL-DS) and link them with the genetic discoveries in the field. We address the manuscript to the pediatric generalist and especially to the next generation of pediatric hematologists.
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Affiliation(s)
- Valentina Sas
- a Department of Hematology , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania.,b Department of Pediatrics , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Cristina Blag
- b Department of Pediatrics , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Gabriela Zaharie
- c Department of Neonatology , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Emil Puscas
- d Department of Surgery , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Cosmin Lisencu
- d Department of Surgery , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Nicolae Andronic-Gorcea
- a Department of Hematology , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Sergiu Pasca
- a Department of Hematology , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Bobe Petrushev
- a Department of Hematology , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Irina Chis
- e Department of Physiology , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Mirela Marian
- f Department of Hematology , Ion Chiricuta Clinical Cancer Center , Cluj Napoca , Romania
| | - Delia Dima
- f Department of Hematology , Ion Chiricuta Clinical Cancer Center , Cluj Napoca , Romania
| | - Patric Teodorescu
- a Department of Hematology , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Sabina Iluta
- a Department of Hematology , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Mihnea Zdrenghea
- f Department of Hematology , Ion Chiricuta Clinical Cancer Center , Cluj Napoca , Romania
| | - Ioana Berindan-Neagoe
- g MedFuture Research Center for Advanced Medicine , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Gheorghe Popa
- b Department of Pediatrics , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Sorin Man
- b Department of Pediatrics , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
| | - Anca Colita
- h Department of Pediatrics , Carol Davila University of Medicine and Pharmacy , Bucharest , Romania.,i Department of Pediatrics , Fundeni Clinical Institute , Bucharest , Romania
| | - Cristina Stefan
- j African Organization for Research and Training in Cancer , Cape Town , South Africa
| | - Seiji Kojima
- k Department of Pediatrics , Nagoya University Graduate School of Medicine , Nagoya , Japan.,l Center for Advanced Medicine and Clinical Research , Nagoya University Hospital , Nagoya , Japan
| | - Ciprian Tomuleasa
- a Department of Hematology , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania.,f Department of Hematology , Ion Chiricuta Clinical Cancer Center , Cluj Napoca , Romania.,m Research Center for Functional Genomics and Translational Medicine , Iuliu Hatieganu University of Medicine and Pharmacy , Cluj Napoca , Romania
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