Which statement about chemotherapy and Down syndrome-associated leukemia is true according to the material?

• A. Down syndrome–associated leukemia has higher survival and lower relapse rates
• B. Down syndrome–associated leukemia has lower survival and higher relapse rates
• C. Down syndrome does not affect leukemia prognosis
• D. Only older children with Down syndrome have leukemia

Answer: (A)

In Down syndrome–associated leukemia, chemotherapy can lead to relatively favorable outcomes, with higher survival and lower relapse rates when the treatment is tailored appropriately. This is because, despite the higher risk of developing leukemia in these patients, the leukemias often respond well to chemotherapy when regimens are adjusted to balance effectiveness with the potential for toxicity. Supportive care to manage infections, cytopenias, and other treatment-related complications is crucial to realizing these better outcomes, though the risk of toxicity remains a significant consideration. The other statements conflict with the material because Down syndrome does affect prognosis and is associated with leukemia in younger children, not only older ones, and the notion of universally lower survival and higher relapse does not align with the reported improvements seen with proper chemotherapy in this population.