Treatment of children with juvenile myelomonocytic leukemia
(JMML)
JMML is fairly rare, so it has been hard to study, and there is no single best
chemotherapy treatment for this leukemia. A stem cell transplant is the treatment of
choice when possible, as it offers the best chance to cure JMML. About half of the
children with JMML who get a stem cell transplant are still free of leukemia after several
years. Sometimes, even if the leukemia recurs, a second stem cell transplant can be
helpful.
Because JMML is hard to treat with current chemo drugs, taking part in a clinical trial
looking at newer drugs may be a good option for children who can’t get a stem cell
transplant.
Treatment of children with chronic myelogenous leukemia
(CML)
This leukemia is rare in children, but it does occur. Treatment in children is similar to
what is used for adults.
Targeted drugs, such as imatinib (Gleevec) and dasatinib (Sprycel), attack cells with the
Philadelphia chromosome, which is the key gene abnormality in CML cells. These drugs
are usually very good at controlling CML, often for long periods of time and with less
severe side effects than chemotherapy drugs. However, these drugs do not seem to cure
CML when used alone, and they must be taken every day.
Imatinib is usually the drug tried first. If it doesn’t work or if it becomes less effective
over time, another drug may be tried. If targeted drugs are no longer helpful, high-dose
chemotherapy with a stem cell transplant offers the best chance for a cure. Doctors are
now studying whether adding targeted drugs to stem cell transplant regimens can help
increase cure rates.
For more information on CML and its treatment, see Leukemia--Chronic Myeloid