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Down's syndrome and increased mean corpuscular volume (MCV), mean platelet volume (MPV) and neutrophil alkaline phosphatase (NAP)

Down's syndrome is associated with multiple hematologic abnormalities. Newborns with Down's syndrome may develop a myelodys-plastic syndrome akin to leukemia. The incidence of acute leukemia is increased in Down's syndrome. These serious hematologic complications of Down's syndrome may be the reflection of a steady state of compensated dysmyelopoiesis.We studied 28 otherwise healthy individuals 10-25 years of age with Down's syndrome with three easily accessible hematologic parameters: MCV, MPV and NAP. The NAP was performed by the azodye method of Ackerman on peripheral blood smears and a numerical score given. MCV and MPV were measured by the Coulter counter S plus IV. The Down's syndrome population had a MCV of 94.1±3.9 fl ([xmacr ;[plusmn;SD) a MPV of 9.3±0.7 fl and an NAP score of 161±54. The normal controls for the Coulter counter model S plus IV in our labaratory are a MCV 87±7 and a MPV of 8.9±1.5. The NAP score in normals has a mean score of 100±50. Down's syndrome mean values for MCV, MPV and NAP differed from the mean of normal population in our laboratory (p = <0.01, <0.05 and <0.01 respectively). MCV, MPV and NAP are all increased in Down's syndrome.Macrocytosis, both of platelets and red cells with disordered metabolism of white cells suggest a state of disordered hematopoiesis in individuals with Down's syndrome.