Abstract
Transient abnormal myelopoiesis (TAM) is a pre-leukaemic syndrome
associated with Trisomy 21 (Down syndrome). TAM typically regresses
without treatment, but if needed TAM cells are exquisitely sensitive to
a short course of low-dose cytarabine (LDAC). A significant minority of
TAM patients progress to myeloid leukaemia of Down Syndrome (MLDS)
requiring intensive chemotherapy. We describe a neonate with unusually
recalcitrant TAM who required four 7-day courses of LDAC. Neonates with
Down syndrome are at significant risk of severe toxicity from
chemotherapy but this was mitigated by the use of repeated courses of
LDAC, without the need for more intensive MLDS treatment.