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Pediatric Myelodysplastic Syndrome Clinical Presentation

  • Author: Prasad Mathew, MBBS, DCH, FAAP; Chief Editor: Jennifer Reikes Willert, MD  more...
Updated: Dec 10, 2015


Children with myelodysplastic syndrome (MDS) have a history consistent with bone marrow failure. Their history and presentation are similar to those of children with leukemia.

The interval between the onset of symptoms and diagnosis is 0-23 months, with a median of 2 months. Patients may be asymptomatic, and the condition may be discovered when a routine complete blood count is obtained.

Other symptoms include the following:

  • Fatigue
  • Systemic infection (bacterial or fungal)
  • Prolonged fever
  • Bruising, bleeding

Physical Examination

Children with MDS have findings consistent with bone marrow failure. The presentation may resemble that of acute leukemia.

General appearances range from well to constitutional wasting. Pallor and fatigue due to anemia may be present. Hepatosplenomegaly predominates in juvenile myelomonocytic leukemia (JMML). Lymphadenopathy is present in 40-76% of patients with JMML but is present in less than 10% of patients with adult-type myelodysplastic syndrome (MDS). About 30% of patients with JMML have a diffuse erythematous, maculopapular rash.

Contributor Information and Disclosures

Prasad Mathew, MBBS, DCH, FAAP Professor of Pediatrics, Division of Hematology/Oncology, University of New Mexico School of Medicine

Prasad Mathew, MBBS, DCH, FAAP is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society of Hematology, American Society of Pediatric Hematology/Oncology, International Society on Thrombosis and Haemostasis, American Society of Clinical Oncology, National Hemophilia Foundation, Hemophilia and Thrombosis Research Society, International Society of Paediatric Oncology, World Federation of Hemophilia

Disclosure: Received salary from Bayer HC for payment for services rendered.


Glenda H Grawe, MD Assistant Professor of Pediatrics, Baylor College of Medicine; Attending Physician, Department of Pediatrics, Section of Emergency Medicine, Texas Children's Hospital

Glenda H Grawe, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Emergency Physicians, Minnesota Medical Association, National Association of EMS Physicians, Texas Pediatric Society, Harris County Medical Society

Disclosure: Received honoraria from Draeger for review panel membership.

Franklin O Smith, III, MD Clinical Director, University of Cincinnati Cancer Institute, Professor of Medicine, Associate Director, Hematology/Oncology Fellowship Training Program, Division of Hematology/Oncology, Department of Internal Medicine, University of Cincinnati College of Medicine; Professor of Pediatrics With Tenure, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine

Franklin O Smith, III, MD is a member of the following medical societies: American Academy of Pediatrics, American Association for Cancer Research, American Pediatric Society, American Society of Gene and Cell Therapy, American Society of Hematology, American Society of Pediatric Hematology/Oncology, American Society for Blood and Marrow Transplantation, American Society of Clinical Oncology, International Society of Paediatric Oncology

Disclosure: Received consulting fee from Wyeth Research for consulting; Received from Seattle Genetics for other.

Chief Editor

Jennifer Reikes Willert, MD Associate Clinical Professor, Department of Pediatrics, Division of Pediatric Hematology/Oncology, Section of Stem Cell Transplantation, Stanford University Medical Center, Lucile Packard Children's Hospital

Jennifer Reikes Willert, MD is a member of the following medical societies: American Academy of Pediatrics, American Society of Hematology, American Society for Blood and Marrow Transplantation, Children's Oncology Group, American Society of Pediatric Hematology/Oncology

Disclosure: Nothing to disclose.


Timothy P Cripe, MD, PhD Professor of Pediatrics, Division of Hematology/Oncology, Cincinnati Children's Hospital Medical Center; Clinical Director, Musculoskeletal Tumor Program, Co-Medical Director, Office for Clinical and Translational Research, Cincinnati Children's Hospital Medical Center; Director of Pilot and Collaborative Clinical and Translational Studies Core, Center for Clinical and Translational Science and Training, University of Cincinnati College of Medicine

Timothy P Cripe, MD, PhD is a member of the following medical societies: American Association for the Advancement of Science, American Pediatric Society, American Society of Hematology, American Society of Pediatric Hematology/Oncology, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Kathleen M Sakamoto, MD, PhD Professor and Chief, Division of Hematology-Oncology, Vice-Chair of Research, Mattel Children's Hospital at UCLA; Co-Associate Program Director of the Signal Transduction Program Area, Jonsson Comprehensive Cancer Center, California Nanosystems Institute and Molecular Biology Institute, University of California, Los Angeles, David Geffen School of Medicine

Kathleen M Sakamoto, MD, PhD is a member of the following medical societies: American Society of Hematology, American Society of Pediatric Hematology/Oncology, International Society for Experimental Hematology, Society for Pediatric Research, and Western Society for Pediatric Research

Disclosure: Nothing to disclose.

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

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