Natural history of transient myeloproliferative disorder clinically diagnosed in Down syndrome neonates: a report from the Children's Oncology Group Study.

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Presentation transcript:

Natural history of transient myeloproliferative disorder clinically diagnosed in Down syndrome neonates: a report from the Children's Oncology Group Study A2971 by Alan S. Gamis, Todd A. Alonzo, Robert B. Gerbing, Joanne M. Hilden, April D. Sorrell, Mukta Sharma, Thomas W. Loew, Robert J. Arceci, Dorothy Barnard, John Doyle, Gita Massey, John Perentesis, Yaddanapudi Ravindranath, Jeffrey Taub, and Franklin O. Smith Blood Volume 118(26):6752-6759 December 22, 2011 ©2011 by American Society of Hematology

Time to TMD resolution from diagnosis for all patients enrolled. Alan S. Gamis et al. Blood 2011;118:6752-6759 ©2011 by American Society of Hematology

OS and EFS from study entry for all TMD patients. Alan S. Gamis et al. Blood 2011;118:6752-6759 ©2011 by American Society of Hematology

OS and mEFS (Mod EFS) from study entry comparing observation to intervention patients. OS and mEFS (Mod EFS) from study entry comparing observation to intervention patients. Deaths that are not TMD related are competing events in modified EFS (1 − cumulative incidence). Alan S. Gamis et al. Blood 2011;118:6752-6759 ©2011 by American Society of Hematology

OS and modified EFS (mEFS) based on diagnostic hepatomegaly and WBC values. OS and modified EFS (mEFS) based on diagnostic hepatomegaly and WBC values. (A) Diagnostic hepatomegaly. (B) WBC values. These illustrate the univariate impact upon OS and modified EFS of these 2 risk factors. Alan S. Gamis et al. Blood 2011;118:6752-6759 ©2011 by American Society of Hematology

OS and modified EFS (Mod EFS) for the 3 risk groups of TMD patients. OS and modified EFS (Mod EFS) for the 3 risk groups of TMD patients. This illustrates that the intermediate risk group, that is, those with hepatomegaly alone, had minimal TMD-related problems but did have significant mortality from other causes. Alan S. Gamis et al. Blood 2011;118:6752-6759 ©2011 by American Society of Hematology

Impact of TMD resolution upon later risk of developing AML Impact of TMD resolution upon later risk of developing AML. This illustrates that those children whose resolution of their TMD exceeded the median resolution time were at greater risk of later developing AML. Impact of TMD resolution upon later risk of developing AML. This illustrates that those children whose resolution of their TMD exceeded the median resolution time were at greater risk of later developing AML. Alan S. Gamis et al. Blood 2011;118:6752-6759 ©2011 by American Society of Hematology