Perspectives on the origin and therapeutic opportunities in Down syndrome-associated leukemia

Down syndrome predisposes children to acute leukemia in both myeloid and lymphoid lineages, with myeloid leukemia showing better prognosis due to higher chemotherapy sensitivity, while lymphoid leukemia has worse outcomes due to treatment toxicity and relapse rates. This review examines the molecular mechanisms underlying these leukemias and explores novel therapeutic approaches to improve survival in children with Down syndrome-associated malignancies.