Treatment of lymphoblastic leukemia in children with Down syndrome

Acute leukemia accounts for 30% of malignant neoplasms in children in Russia. Down’s syndrome (trisomy of chromosome 21) is considered one of the strongest predictors of acute leukemia. Genetic abnormalities in patients with Down syndrome are strategically important for treatment approaches, metabolism of certain drugs, and sensitivity of blast cells to chemotherapy. The article describes three clinical cases of patients with acute lymphoblastic leukemia with Down’s syndrome who developed severe complications requiring correction of the dosage of chemotherapy. This cohort of patients is at high risk for the development of hematological, metabolic and infectious complications that require individualization of regimens and dosage of chemotherapy drugs.