We agree with Dr Pinkel that a careful investigation for an infectious cause is mandatory in all children suspected as suffering from JMML. Until the chromosomal and molecular abnormalities of the majority of JMML patients with so-called "normal karyotype" have been unraveled, the diagnosis of JMML will have to be based on a number of clinical and laboratory features (Table 1).
The suggestive clinical features, the minimal laboratory criteria, and the criteria requested for definite diagnosis may prove to be a guideline in establishing the diagnosis of JMML