International Journal of Hematology

, Volume 93, Issue 2, pp 192–198 | Cite as

Acute lymphoblastic leukemia and Down syndrome: the collaborative study of the Tokyo Children’s Cancer Study Group and the Kyushu Yamaguchi Children’s Cancer Study Group

  • Hiroaki GotoEmail author
  • Takeshi Inukai
  • Hiroyasu Inoue
  • Chitose Ogawa
  • Takashi Fukushima
  • Miharu Yabe
  • Akira Kikuchi
  • Kazutoshi Koike
  • Keitaro Fukushima
  • Keiichi Isoyama
  • Tomohiro Saito
  • Akira Ohara
  • Ryoji Hanada
  • Jiro Iwamoto
  • Noriko Hotta
  • Yoshihisa Nagatoshi
  • Jun Okamura
  • Masahiro Tsuchida
Original Article


The Tokyo Children’s Cancer Study Group (TCCSG) and the Kyushu Yamaguchi Children’s Cancer Study Group (KYCCSG) performed a collaborative analysis of data on children with Down syndrome and acute lymphoblastic leukemia (DS-ALL). Among the 1,139 patients who were enrolled in the TCCSG L99-15, L99-1502, or the KYCCSG ALL 96 study, 13 patients with newly diagnosed ALL had DS. In the DS patients, a significantly higher proportion of patients developed ALL at age 5 years or older compared with the non-DS ALL patients (P < 0.001). The 5-year relapse-free or overall survival of DS-ALL patients was 50.0 or 61.5%, respectively. Relapse accounted for all causes of death. In the TCCSG L99-15 cohort, the overall survival of DS-ALL patients was 42.9%, which was significantly worse compared with 87.9% in the non-DS population (P < 0.001). The survival of patients who received reduced-dose chemotherapy was significantly worse than those who received full-dose chemotherapy (P < 0.001). However, a higher dose of methotrexate was not associated with a better outcome. Results of our preliminary study suggest that the survival of DS-ALL patients could be improved by treatment without dose reduction if possible, although the appropriate dose of methotrexate for DS-ALL needs to be determined.


Acute lymphoblastic leukemia Down syndrome Chemotherapy Children 


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Copyright information

© The Japanese Society of Hematology 2011

Authors and Affiliations

  • Hiroaki Goto
    • 1
    Email author
  • Takeshi Inukai
    • 2
  • Hiroyasu Inoue
    • 3
  • Chitose Ogawa
    • 4
  • Takashi Fukushima
    • 5
  • Miharu Yabe
    • 6
  • Akira Kikuchi
    • 7
  • Kazutoshi Koike
    • 8
  • Keitaro Fukushima
    • 9
  • Keiichi Isoyama
    • 10
  • Tomohiro Saito
    • 11
  • Akira Ohara
    • 12
  • Ryoji Hanada
    • 13
  • Jiro Iwamoto
    • 14
  • Noriko Hotta
    • 15
  • Yoshihisa Nagatoshi
    • 16
  • Jun Okamura
    • 16
  • Masahiro Tsuchida
    • 8
  1. 1.Department of PediatricsYokohama City University, School of MedicineYokohamaJapan
  2. 2.Department of PediatricsUniversity of Yamanashi, School of MedicineKohuJapan
  3. 3.Division of OncologyKanagawa Children’s Medical CenterYokohamaJapan
  4. 4.Department of PediatricsSt. Luke’s International HospitalTokyoJapan
  5. 5.Department of Pediatrics, School of MedicineUniversity of TsukubaTsukubaJapan
  6. 6.Department of Cell TransplantationTokai University HospitalIseharaJapan
  7. 7.Department of Pediatrics, Faculty of MedicineUniversity of TokyoTokyoJapan
  8. 8.Department of Pediatric Hematology and OncologyIbaraki Children’s HospitalMitoJapan
  9. 9.Department of PediatricsDokkyo Medical UniversityMibuJapan
  10. 10.Department of PediatricsShowa University, School of Medicine, Fujigaoka HospitalYokohamaJapan
  11. 11.Department of Health PolicyNational Center for Child Health and DevelopmentTokyoJapan
  12. 12.Department of First Pediatrics, Toho University Medical CenterOomori HospitalTokyoJapan
  13. 13.Department of Hematology/OncologySaitama Children’s Medical CenterIwatsukiJapan
  14. 14.Department of PediatricsAso-Iizuka HospitalIizukaJapan
  15. 15.Department of PediatricsYamaguchi University Graduate School of MedicineYamaguchiJapan
  16. 16.Section of PediatricsNational Kyushu Cancer CentreFukuokaJapan

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