Study Finds Children with Down Syndrome Have Higher Risk of AML

Children with Down syndrome have an estimated 150-fold higher risk of developing acute myeloid leukemia (AML) before age five, compared to children without Down syndrome, according to a new study published in The Journal of Pediatrics.

Researchers led by Emily Marlow, PhD, from the University of California (UC) Davis, examined data from more than 3.9 million pediatric patients born between 1996 and 2016 in seven U.S. health care systems or in Ontario, Canada, who were diagnosed with leukemia.

When the study authors adjusted for health system, child’s age at diagnosis, birth year, and sex, they found that 2.8% of children with Down syndrome were diagnosed with leukemia, compared with 0.05% of other children. Regardless of age, children with Down syndrome had a higher risk of acute lymphocytic leukemia (ALL). Those with Down syndrome between ages 2 and 4 were more likely to develop ALL, while AML was more common in younger patients, particularly during the first year of life.

In addition, researchers discovered that males and Hispanic patients were more likely to be diagnosed with Down syndrome and develop leukemia than other groups, while white children were more likely to develop ALL and more likely to have Down syndrome than Black children.

“One main strength of this study is its large cohort with more leukemia cases in children with Down syndrome than most previous studies,” said Dr. Marlow. “This allowed more precise risk estimation, especially for rare leukemia types such as AML-7, previously estimated from small case reports.”

Sources: UC Davis news release, April 6, 2021; Marlow EC, Ducore J, Kwan ML, et al. Leukemia Risk in a Cohort of 3.9 Million Children with and without Down Syndrome. J Pediatr. 2021;S0022-3476(21)00212-2. doi:10.1016/j.jpeds.2021.03.001. 2021 Mar 6. [Epub ahead of print]