Stem cell transplantation is the most common treatment for JMML. Standard chemotherapy, despite its intensity, has helped only a small number of patients. Some patients have reacted favorably to 13-cis-retinoic acid therapy (Accutane®). The drug has been able to stabilize the disease and bring it into a partial remission.
Allogeneic Stem Cell Transplantation
An allogeneic stem cell transplantation offers the only known cure for JMML and is widely used to treat the disease. Up to 50 percent of patients have achieved long-term survival, but up to 30 percent to 40 percent of those patients have suffered relapses.
Although it's not the only type of stem cell transplantation, allogeneic stem cell transplantation is the most common. Allogeneic transplantation involves transferring stem cells from a healthy person (the donor) to the patient. The procedure follows high-intensity chemotherapy, potent drugs that must be toxic enough to kill leukemic cells. Unfortunately, the drugs also take aim at normal stem cells in the bone marrow.
The main reasons for doing an allogeneic stem cell transplant are to:
- give strong doses of chemotherapy to kill JMML cells
- start a new supply of red cells, white cells and platelets with help from the transplanted donor stem cells
Some patients undergo a second allogeneic transplantation. A second transplantation can be effective when used with reduced immunosuppression. This method presumably helps donor immune cells better fight the disease. This attack is called the graft-versus-tumor (GVT) effect.