Abstract
A case of childhood acute leukemia associated with Down's syndrome is reported. The patient was three year-old girl at the time of diagnosis of acute leukemia, and had typical clinical features of Down's syndrome with 21 trisomy.
She was transferred to the National Cancer Center Hospital because of hepatosplenomegaly, severe anemia and marked leukocytosis.
At first, the patient responded well to a combination chemotherapy with daunorubicin, cytosine arabinoside, vincristine and predonisolone. Complete remission was obtained for four months. She relapsed, however, and died of septicemia of pseudomonas aeruginosa fifteen months after the diagnosis.
Children with Down's syndrome have a higher incidence of acute leukemia than normal children. The cell type of the acute leukemia, i. e. myeloblastic or lymphoblastic, is still controversial. Leukemic cells in this case had both myeloid and lymphoid expression of the surface markers, such as E-receptor, complement and Fc receptors, T-cell and Ia-like antigens as well as myeloid antigen. TdT activity was not recognized. The presence of both myeloid and lymphoid expression suggested that the neoplastic change occurred at the level of myeloid-lymphoid stem cell. These findings may be concerned with chromosomal abnormality of Down's syndrome.
