Cancer

Transient myelo-proliferative disorder, which sometimes develops into leukemia, is seen in 10% of neonates with Down syndrome. Polycythemia is also common in infancy. But the most significant forms of cancer in youngsters with Down syndrome is leukemia.

In younger children with Down syndrome, acute myelogenous leukemia (AML) and other lymphocytic leukemias are most common. Older children with Down syndrome are more likely to be diagnosed with acute lymphoblastic leukemia (ALL).

Nurses caring for these children should report any signs of early leukemia to the primary health care provider, including:

• fatigue over a 2-6 week period
• fever
• pallor
• easy bruising or hemorrhages
• joint or bone pain
• life-threatening systemic infection or hemorrhage
  

The good news is that leukemia in children with Down syndrome usually responds very well to standard treatments, and goes into remission readily. This information is important for nurses to convey to the child’s parents.