{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T03:58:06Z","timestamp":1789012686979,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,4,18]],"date-time":"2013-04-18T00:00:00Z","timestamp":1366243200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Children with <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>own syndrome (<jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content>) have a greater risk for developing both acute lymphoblastic leukaemia (<jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content>) and significant adverse effects of chemotherapy. We investigated their outcome with, and tolerance of, treatment protocols for relapsed <jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content> optimized in the paediatric population without <jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content>. Probability of survival and causes of treatment failure were determined for 49 children with <jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content> and a matched cohort of 98 children without <jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content> among 2160 children treated for relapsed <jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content> in clinical trials conducted by the <jats:styled-content style=\"fixed-case\">B<\/jats:styled-content>erlin\u2010<jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>rankfurt\u2010<jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>\u00fcnster <jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content> Relapse Study Group between 1983 and 2012. Despite more favourable <jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content> relapse characteristics, children with <jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content> experienced lower event\u2010free (<jats:styled-content style=\"fixed-case\">EFS<\/jats:styled-content>) and overall survival (<jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content>) than the control group without <jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">EFS<\/jats:styled-content> 17\u00a0\u00b1\u00a008% vs. non\u2010<jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content> 41\u00a0\u00b1\u00a006%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7006; <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> 17\u00a0\u00b1\u00a009% vs. non\u2010<jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content> 51\u00a0\u00b1\u00a006%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001). Children with <jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content> developed more frequently fatal complications of treatment (34\u00a0\u00b1\u00a007% vs. non\u2010<jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content> 10\u00a0\u00b1\u00a004%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7001). During the last decade, <jats:styled-content style=\"fixed-case\">EFS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> were no longer significantly different in children with and without <jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">EFS<\/jats:styled-content> 31\u00a0\u00b1\u00a009% vs. 36\u00a0\u00b1\u00a009%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7399; <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> 31\u00a0\u00b1\u00a012% vs. 53\u00a0\u00b1\u00a009%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7151). <jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content> proved an independent prognostic factor of outcome after <jats:styled-content style=\"fixed-case\">ALL<\/jats:styled-content> relapse. Induction deaths and treatment\u2010related mortality but not subsequent relapse were the main barrier to successful outcomes of relapse therapy in children with <jats:styled-content style=\"fixed-case\">DS<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/bjh.12348","type":"journal-article","created":{"date-parts":[[2013,4,18]],"date-time":"2013-04-18T10:52:21Z","timestamp":1366282341000},"page":"98-106","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Outcomes of treatment for relapsed acute lymphoblastic leukaemia in children with <scp>D<\/scp>own syndrome"],"prefix":"10.1111","volume":"162","author":[{"given":"Franziska","family":"Meyr","sequence":"first","affiliation":[{"name":"Paediatric Haematology\/Oncology Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Escherich","sequence":"additional","affiliation":[{"name":"Paediatric Oncology\/Haematology University Medical Centre Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Mann","sequence":"additional","affiliation":[{"name":"St. Anna Children's Hospital Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Klingebiel","sequence":"additional","affiliation":[{"name":"Department of Paediatric Haematology, Oncology and Haemostaseology University Children's Hospital of Frankfurt\/Main Goethe\u2010University Frankfurt am Main Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Kulozik","sequence":"additional","affiliation":[{"name":"Department of Paediatric Oncology, Haematology and Immunology University of Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Rossig","sequence":"additional","affiliation":[{"name":"Department of Paediatric Haematology and Oncology University Children's Hospital Muenster Muenster Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Schrappe","sequence":"additional","affiliation":[{"name":"University Medical Centre Schleswig\u2010Holstein Christian\u2010Albrechts\u2010University Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fcnter","family":"Henze","sequence":"additional","affiliation":[{"name":"Paediatric Haematology\/Oncology Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arend","family":"von Stackelberg","sequence":"additional","affiliation":[{"name":"Paediatric Haematology\/Oncology Charit\u00e9\u2010Universit\u00e4tsmedizin Berlin Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann","family":"Hitzler","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,4,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(89)80603-1"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.03.3373"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20193"},{"key":"e_1_2_7_5_1","first-page":"1783","article-title":"Proposals for the immunological classification of acute leukemias. 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