• Patients age \>= 6 and \< 40 years at the time of enrollment

• A diagnosis of Down syndrome is required, and may include any of the three recognized types: trisomy 21 resulting from chromosomal nondisjunction (most common), translocation (the patient has 46 chromosomes, but all or part of an additional copy of chromosome 21 is attached to another chromosome), or mosaicism (trisomy 21 that is present in only a fraction of cells)

• All patients must be DS-AL survivors (acute lymphoblastic leukemia \[ALL\] or acute myeloid leukemia \[AML\])

⁃ Note: Myeloid leukemia of Down syndrome (ML-DS) would be included under AML category above. Also note that survivors of relapsed disease are eligible, so long as the patient otherwise meets eligibility criteria, i.e., treatment for relapse was completed at least 36 calendar months prior to enrollment and did not include stem cell transplant

• Patients must have been treated for ALL or AML

⁃ Note: History of COG therapeutic trial participation is not required. As a reminder ML-DS would be included under the AML category here above

• All cancer treatment (oral or intravenous) must have been completed at least 36 calendar months prior to enrollment

• Patients must have a life expectancy of \> 1 year

• Patient and parent of subject must be either English or Spanish speaking. At least one parent or guardian must be able to read and write in English or Spanish

⁃ Note: Parents or guardians are responsible for completing all forms, even in the case of subjects that are \>= 18 years old

• All patients and/or their parents or legal guardians must sign a written informed consent

• All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met