Pediatric Myeloid neoplasms are clonal diseases originating from hematopoietic stem cells or committed myeloid progenitors. While the incidence of pediatric myeloid neoplasms is generally much lower than that of adults, with an estimated rate of less than 1 in 100,000, an exception is juvenile myelomonocytic leukemia (JMML), which is exclusively seen in pediatric patients.¹ Although the genomic profile of pediatric neoplasms can often be linked to their corresponding adult diseases, there are some notable differences that may reflect less exposure to environmental carcinogens.^2,3 Pediatric myeloid neoplasms generally have a better prognosis than their adult counterparts due to a higher prevalence of good prognostic genomic markers in pediatric patients.⁴ In addition, children are more resilient than adults and are capable of tolerating intensive chemotherapy.