Down syndrome is a genetic condition in which a person has an extra copy of chromosome 21, resulting in 47 chromosomes instead of the typical 46. This additional chromosome can impact physical development and learning abilities. Leukemia, on the other hand, occurs when the body produces an excess of immature white blood cells, which can interfere with normal blood function.
The Centers for Disease Control and Prevention (CDC) estimates that around 6,000 babies (about 1 in 700) are born with Down syndrome each year in the United States. Children with Down syndrome are significantly more prone to developing leukemia. They are 33 times more likely to develop acute lymphoblastic leukemia (ALL) and 150 times more likely to develop acute myeloid leukemia (AML) compared to children without Down syndrome. Additionally, they have an increased risk of a rare subtype of AML called acute megakaryoblastic leukemia (AMKL).
The cure rate for ALL in children with Down syndrome is 60-70%, which is lower than in the general population. According to Leukemia Care, this reduced cure rate may be due to their higher susceptibility to infections and adverse reactions to chemotherapy. However, the cure rate for AML in children with Down syndrome is relatively high, at 80-100%. Researchers suggest that genetic factors, particularly mutations in the JAK2 gene and alterations in the CRLF2 gene, may contribute to this increased leukemia risk. These genetic changes are commonly found in children with Down syndrome who develop ALL.
Children with Down syndrome also exhibit other biological differences, including an increased number of red blood cells and a higher number of mitochondria as they grow older. While mitochondria are vital for cellular energy production, an excess can damage cells by producing reactive oxygen species, which are harmful molecules that can attack DNA. According to Dr. Andrew Marderstein from Stanford University, "These harmful molecules, called reactive oxygen species, are known to attack DNA, creating mutations that can lead to pre-leukemia and, eventually, leukemia."
The symptoms of leukemia are generally similar in children with or without Down syndrome. Common signs include:
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Frequent infections
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Easy bleeding and bruising
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Increased fatigue
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Pale skin
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Sensitivity to cold
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Weakness
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Blood spots or rashes on the skin
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Difficulty breathing
Children with Down syndrome also tend to have a higher relapse rate compared to other children with leukemia.
In conclusion, children with Down syndrome face a greater risk of developing leukemia. Recognizing the early symptoms of leukemia is crucial for timely diagnosis and treatment.
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