Which of the following is not compatible with a diagnosis of juvenile myelomonocytic leukemia

Juvenile myelomonocytic leukemia (JMML) is a serious chronic leukemia (cancer of the blood) that affects children mostly aged 4 and younger. The name JMML now encompasses all diagnoses formerly referred to as juvenile chronic myeloid leukemia (JCML), chronic myelomonocytic leukemia of infancy, and infantile monosomy 7 syndrome. The average age of patients at diagnosis is 2 years old. The World Health Organization has included JMML in the category of myelodysplastic and myeloproliferative disordersDiagnosis Edit The following criteria are required in order to diagnose JMML: All 3 of the following: No Philadelphia chromosome or BCR/ABL fusion gene. Peripheral blood monocytosis >1 x 109/L. Less than 20% blasts (including promonocytes) in the blood and bone marrow (blast count is less than 2% on average) Two or more of the following criteria: Hemoglobin F increased for age. Immature granulocytes and nucleated red cells in the peripheral blood. White blood cell count >10 x 109/L. Clonal chromosomal abnormality (e.g., monosomy 7). Granulocyte macrophage colony-stimulating factor (GM-CSF) hypersensitivity of myeloid progenitors in vitro. These criteria are identified through blood tests and bone marrow tests. Blood tests: A complete blood count (CBC) will be performed on a child suspected of having JMML and throughout the treatment and recovery of a child diagnosed with JMML. The differential diagnosis list includes infectious diseases like Epstein-Barr virus, cytomegalovirus, human herpesvirus 6, histoplasma, mycobacteria, and toxoplasma, which can produce similar symptoms.