1. ? TRISOMY 21 Perturbed Haematopoiesis Fetal Liver Neonatal Childhood
MICROENVIRONMENT
GROWTH FACTORS/
CYTOKINES (IGF?)
Perturbed Haematopoiesis ?
MYELOPOIESIS
Acquired GATA1 mutation(s)
Expansion of HSC with MK/erythroid bias
Expansion of MEP
Increased megakaryocytes
TRANSIENT
ABNORMAL MYELOPOIESIS (TAM)
MYELOID LEUKAEMIA
OF DOWN SYNDROME
(ML-DS)
Additional genetic events
Additional genetic
events
Reduced B progenitors
(ELP-> PreproB block)
Reduced B cells
ACUTE LYMPHO-BLASTIC LEUKAEMIA
LYMPHOPOIESIS
Including
CRLF2/JAK2
mutations
TRISOMY 21