Epidemiology of Acute Leukemia among Children with Down Syndrome in Korea

Area of Science:

• Pediatric Oncology
• Genetics and Genomics
• Epidemiology

Background:

• Children with Down syndrome (DS) exhibit a heightened susceptibility to developing acute leukemia compared to the general pediatric population.
• Understanding the epidemiological characteristics of leukemia in children with DS is crucial for targeted healthcare strategies.

Purpose of the Study:

• To investigate the nationwide incidence of acute leukemia in children with Down syndrome (DS) in Korea.
• To compare the epidemiologic features and outcomes of acute leukemia between children with and without DS.

Main Methods:

• Utilized the National Health Insurance Service database to identify pediatric patients (0-19 years) diagnosed with acute leukemia between 2007 and 2016.
• Analyzed demographic data, leukemia subtypes (acute lymphoblastic leukemia [ALL] and acute myeloid leukemia [AML]), and survival rates for children with and without DS.

Main Results:

• Out of 4,697 pediatric leukemia cases, 54 (1.1%) had DS. The incidence of leukemia was substantially higher in children with DS (49.25 times for overall leukemia, 20.75 for ALL, 163.38 for AML).
• Children with DS were diagnosed at a younger age (median 3 years vs. 9 years) and had a higher proportion of AML (66.7% vs. 32.4%) compared to the non-DS group.
• The 5-year overall survival rate was comparable between the DS and non-DS groups (88.0% vs. 81.9%).

Conclusions:

• The incidence of acute leukemia is significantly elevated in children with Down syndrome in Korea.
• Despite increased incidence and differences in subtype distribution and age at diagnosis, children with DS and acute leukemia demonstrate comparable overall survival rates to their non-DS counterparts.