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About Childhood MDS

  • MDS is not common in children, accounting for less than 5 percent of all blood cancers in children.
  • The median age at diagnosis in children is 7 years old.
  • Blood and bone marrow tests are needed to make a diagnosis.

Like the adult version of MDS, childhood MDS is separated into two categories:

  • primary MDS for cases that have no obvious cause
  • treatment-related and secondary MDS for cases that have an obvious cause

Your child's treatment options depend on whether he or she has primary or treatment-related and secondary MDS.

Primary MDS

Refractory cytopenia (RC) is the most common subtype of childhood MDS. About half of all children with MDS are diagnosed with RC. The subtype is difficult to diagnose. Before your doctor can confirm an RC diagnosis, your child must undergo careful physical examinations and repeat bone marrow tests. The doctor also considers your child's medical history.

Treatment-Related and Secondary MDS

Another name for treatment-related and secondary MDS is therapy-related MDS (tMDS). Between 7 percent and 18 percent of childhood cancers are therapy related.

Treatment-related and secondary MDS in children is associated with:

  • Prior chemotherapy or radiation therapy. Children who have MDS might have previously received radiation therapy or chemotherapy treatment for another cancer(s).
  • Prior acquired aplastic anemia. Children born with bone marrow disorders such as Fanconi anemia, severe congenital neutropenia or Schwachman-Diamond syndrome have a higher risk of developing MDS.
  • Familial MDS. Children who have a first-degree relative (mother, father, brothers or sisters) with MDS are at higher risk for the disease.

Children with treatment-related and secondary MDS tend to have less favorable treatment outcomes than children with primary MDS do. Allogeneic stem cell transplantation is an option for patients with a congenital bone marrow failure disorder if the transplant would be the same treatment approach for the disorder.

Childhood MDS Subtypes

Subtypes of primary childhood MDS are based on the World Health Organization's (WHO's) adult MDS classification.



Refractory cytopenia (RC)
  • less than 2 percent blasts in the blood
  • less than 5 percent blasts in the marrow
Refractory anemia with excess blasts (RAEB)
  • 2 percent to 19 percent blasts in the blood
  • 5 percent to 19 percent blasts in the marrow
RAEB in transformation (RAEB-T) 20 percent to 29 percent blasts in the blood or marrow
All other types All others that can't be classified into the above groups

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last updated on Friday, March 16, 2012

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