PEDIATRICS Vol. 78 No. 4 October 1986, pp. 688-691
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Bone Marrow Transplantation for Children With Acute Leukemia and Down Syndrome

Charles M. Rubin MD1, Maura O'Leary MD1, Penelope A. Koch MD1, and Mark E. Nesbit Jr MD1

1 From the Bone Marrow Transplant Centers at the University of Minnesota, Minneapolis, Roswell Park Memorial Institute, Buffalo, New York, and Montreal Children's Hospital, Montreal

Four children with acute leukemia and Down syndrome received high-dose cyclophosphamide therapy and total body irradiation in preparation for bone marrow transplantation. Skin and mucous membrane toxicity was pronounced. Furthermore, three children died during the immediate posttransplantation period of infectious and hemorrhagic pulmonary complications. One patient had hematologic recovery and is surviving disease-free 1 year following transplantation. These preliminary observations are in agreement with previous data suggesting that children with Down syndrome are at higher risk for toxicity, pneumonitis, and, possibly, death following administration of intensive therapy for leukemia in comparison with children without Down syndrome. Improvements in the management of these children in the future will depend upon a better understanding of the biologic and pathophysiologic aspects of Down syndrome and additional clinical experience.

Key Words: bone marrow transplantation • acute leukemia • Down syndrome

Submitted on May 28, 1985
Accepted on July 3, 1985




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