Mortality associated with Down's syndrome in the USA from 1983 to 1997: a population-based study

Yang, Quanhe; Rasmussen, Sonja A.; Friedman, Jan M.

doi:10.1016/s0140-6736(02)08092-3

Cited by 738 publications

(665 citation statements)

References 27 publications

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“…Historically, children with DS were thought to respond poorly to chemotherapy [5,6]. Following a change in societal attitudes during the early 1990s, the overall mortality rate of young children with DS has decreased [7] and treatment of children with acute leukemia and DS is now considered feasible. Treatment of ALL in children with DS, however, continues to face a dilemma.…”

Section: Introductionmentioning

confidence: 99%

Outcome and toxicity of chemotherapy for acute lymphoblastic leukemia in children with down syndrome

Shah

Al-Ahmari

Alyamani

et al. 2008

Pediatric Blood & Cancer

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Background. Acute lymphoblastic leukemia (ALL) in children with Down syndrome (DS) presents with an increased incidence, higher frequency of adverse effects and inferior probability of survival. Attempts at improving outcomes face the dilemma posed by the need to avoid excessive toxicity while maintaining the efficacy of treatment. Dose reductions and avoidance of infusions of intermediate and highdose methotrexate are common in this group. Procedure. In a matched pair analysis we compared adverse effects and survival after ALL chemotherapy using intermediate and high doses of methotrexate in children with and without Down syndrome. Results. Following intermediate and high doses of methotrexate to treat primary ALL, children with DS did not require opiate analgesia and parenteral nutrition for severe mucositis more often than children without DS. Children with DS spent more days in hospital and missed more doses of maintenance chemotherapy. Chemotherapy dose reductions were common and in this study had no detectable adverse impact. Event-free and overall survival (OS) of children with ALL was lower in the DS than the non-Down syndrome (NDS) control group. The difference, however, was no longer significant during the recent treatment era. Conclusions. The feasibility of all treatment elements that are efficacious in pediatric ALL needs to be carefully considered in children with DS. In addition to survival data, the prospective collection of data on both adverse events and treatment modifications is essential to strike a balance between the avoidance of adverse effects and the need for intensive therapy that will safely improve ALL outcomes in this group.

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Section: Introductionmentioning

confidence: 99%

Outcome and toxicity of chemotherapy for acute lymphoblastic leukemia in children with down syndrome

Shah

Al-Ahmari

Alyamani

et al. 2008

Pediatric Blood & Cancer

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“…It also found a difference in organ site and histology distribution of solid neoplasms. 1 In adults this was confirmed in 3 subsequent epidemiologic studies on cancer incidence and on causes of death in DS conducted in Denmark, 2 Israel 3 and the United States, 4 showing a very low incidence of carcinomas while germ cell tumours were more frequent than in the general population. However, for children Ͻ15 years of age, these studies could not provide sufficient data.…”

Section: Dear Sirmentioning

confidence: 80%

“…Interestingly, the excess of germ cell tumours, particularly of the testis, is also observed in adults with DS. 4,8 Yours sincerely, Daniel SATGÉ*, Annie J. SASCO and Brigitte LACOUR…”

Section: Dear Sirmentioning

confidence: 99%

Are solid tumours different in children with Down's syndrome?

Satgé¹,

Sasco²,

Lacour³

2003

Intl Journal of Cancer

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“…Societal attitudes regarding the institutionalization of people with intellectual/developmental disabilities underwent a radical transition beginning in the 1960's, resulting in the depopulation and closing of many of the nation's institutions that continues to this day (Landesman-Dwyer, 1981). Medical factors included the availability of corrective surgery for congenital cardiac problems , common in children with Down syndrome (Yang, Rasmussen, & Friedman, 2002), and all the other general advances in medical care, nutrition and public health practices that have resulted in extensions of life expectancy for all Americans (Silverman, Zigman, Kim, KrinskyMcHale, & Wisniewski, 1998).…”

Section: Introductionmentioning

confidence: 99%

“…Causes of higher mortality rates later in life may be due to a number of factors, two of which are an increased risk for dementia due to Alzheimer's disease and an apparent tendency toward premature aging (Yang et al, 2002). Dementia is defined in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) as the development of multiple cognitive deficits, involving memory, and aphasia [language impairment], apraxia [motor impairment], agnosia [perceptual impairment] or disturbance in executive functioning.…”

Section: Introductionmentioning

confidence: 99%