Abstract • 23

Myelodysplasia (MDS) in children differs from adults in its diverse pathogenic origins and biological features. The FAB classification provides an effective descriptive and prognostic system for adults, but is not applicable in many cases of childhood MDS as they do not fit into any of the five FAB categories. Further, the FAB classification fails in its ability to prognosticate in pediatric MDS, especially those associated with a constitutional syndrome. To solve this problem, we developed a definitive, all-inclusive classification system for MDS of childhood. The classification was presented to two international teams of experts for approval which resulted in the revised, comprehensive, schema contained herein. We then analyzed 40 pediatric cases with MDS confirmed by 4 hematologists between 1988 and 1998 to test the utility of the classification. Cases were classified according to 3 main features (each beginning with "C"):

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