What is the treatment for JMML?
Specific treatment for JMML will be determined by your child's physician based on:
- your child's age, overall health and medical history
- the extent of the disease
- your child's tolerance for certain medications, procedures or therapies
- how your child's physician expects the disease to progress
- your opinion or preference
Treatment components may include the following (alone or in combination):
Chemotherapy is a drug treatment that works by interfering with the cancer cell's ability to grow or reproduce. For JMML, chemotherapy is not generally a successful treatment; however, it may be used to keep the leukemia under control while your child is prepared for a stem cell transplant.
How is chemotherapy given?
Different chemotherapies may be given:
- as a pill to swallow
- as an injection into the muscle or fat tissue
- intravenously (directly to the bloodstream, also called IV)
- intrathecally (directly into the spinal column with a needle)
How is chemotherapy used?
This depends on many factors. Some things to keep in mind:
- A number of combinations of chemotherapy drugs are currently being used to stabilize, and in some cases, shrink the size of the tumor.
- Depending on the type of cancer, chemotherapy drugs may be given in a specific order.
- Chemotherapy may be used alone for some types of cancer, or in conjunction with other therapy such as radiation or surgery.
Does chemotherapy come with bad side effects?
While chemotherapy can be quite effective, the drugs do not differentiate normal healthy cells from cancer cells. Because of this, there can be many adverse side effects during treatment. Being able to anticipate these side effects can help your child, family and your child's health care team prepare for and sometimes prevent these symptoms from occurring.
Stem cell transplant
Stem cell transplantation offers the best option for overcoming JMML. Stem cells are a specific type of cell from which all blood cells develop. They can develop into red blood cells to carry oxygen, white blood cells to fight disease and infection, and platelets to aid in blood clotting. Stem cells are found primarily in the bone marrow, but some also circulate in the blood stream.
When your child's stem cells are replaced with those of a healthy and compatible donor, it is called allogeneic transplantation:
- Treatment may begin with high-dose chemotherapy (perhaps combined with radiation therapy) to destroy all of the bone marrow, stem cells and cancerous cells, in your child's body.
- Then, healthy stem cells from another person (whose tissue must be the same, or almost the same as your child's) are used to help restore your child's normal blood production.
Biological therapy refers to a wide range of substances that may be able to involve the body's own immune system to fight cancer or lessen harmful side effects of some treatments.
Other medications may be given to prevent or treat damage to other systems of your child's body caused by leukemia treatment; or for nausea and side effects of treatment.
A blood transfusion could replace or supplement your child's red blood cells and platelets.
Your child may be given antibiotics may be given to prevent or treat infections.
Continuous follow-up care
Your child's health will be closely monitored to determine response to treatment, detect recurrent disease and manage late effects of treatment.
What are the various stages of JMML?
JMML does not have the three phases (chronic phase, accelerated phase and blast crisis) that are common in CML.
What is the long-term outlook for a child with JMML?
Your child's prognosis greatly depends on:
- the extent of the disease
- his age and overall health
- his tolerance of specific medications, procedures or therapies
- new developments in treatment
Relapse can occur during any stage of treatment, even with aggressive therapy, or may occur months or years after treatment has ended.
As with any cancer, prognosis and long-term survival can vary greatly. Prompt medical attention and aggressive therapy are important for the best prognosis, and continuous follow-up care is essential. New methods are continually being discovered to improve treatment and decrease side effects of the treatment for the disease.