Juvenile Myelomonocytic Leukemia (JMML)

Print this page Bookmark and Share
Parents

About Leukemia

Leukemia is a type of cancer that affects the body's white blood cells (WBCs).

Normally, WBCs help fight infection and protect the body against disease. But in leukemia, WBCs turn cancerous and multiply when they shouldn't, resulting in too many abnormal WBCs. These cells then interfere with the body's ability to function normally.

Juvenile myelomonocytic leukemia (JMML) is a rare childhood cancer that usually happens in children younger than 2 years old. In JMML, too many myelocytes and monocytes (two types of WBCs) are produced from immature blood stem cells called blasts. These myelocytes, monocytes, and blasts overwhelm the normal cells in the bone marrow and other organs, causing the symptoms of JMML.

Causes

The cause of JMML is unknown, but doctors do know that certain medical conditions — such as neurofibromatosis type 1 and Noonan syndrome — can make a child more likely to develop it.

Signs and Symptoms

JMML tends to progress slowly, so at first a child may have few if any symptoms. In fact, symptoms can take months or even years to develop.

The symptoms of all types of leukemia are generally the same and include:

  • fatigue (tiredness) and weakness
  • swollen lymph nodes
  • recurrent infections (such as bronchitis or tonsillitis)
  • fever
  • easy bruising
  • bone and joint pain
  • abdominal pain (caused by abnormal blood cells building up in organs like the kidneys, liver, and spleen)
  • swelling of the spleen and abdomen

Diagnosis

A doctor who suspects a child has leukemia may order tests that include:

  • Blood tests. Tests such as a complete blood count, liver and kidney function panels, and blood chemistries can give important information about the number of normal blood cells in the body and how well the organs are functioning. The blood cells are viewed under a microscope to check for abnormal shapes or sizes.
  • Bone marrow aspiration. In this procedure, the doctor inserts a needle into a large bone, usually the hip, and removes a small amount of bone marrow to examine it for abnormal cells.
  • Imaging studies. These may include an X-ray, CT scan, MRI, or ultrasound to check for an enlarged spleen or liver, and also to rule out any other possible causes of a child's symptoms.
  • Lumbar puncture. Also called a spinal tap, this procedure uses a hollow needle to remove a small amount of cerebrospinal fluid (CSF), the fluid surrounding the brain and spinal cord, for examination in a lab.
  • Flow cytometry tests. Using markers on leukemia cells collected from the blood, bone marrow, and/or CSF, doctors can determine the type of leukemia a child has. This is important because treatments may vary according to the type of leukemia.
  • Chromosomal tests. Analyzing DNA from the blood or bone marrow is another way that doctors can learn which type of leukemia a child has.
  • Tissue typing or HLA (human leukocyte antigen) typing. If a child needs a stem cell transplant (also called a bone marrow transplant), this test helps doctors find a suitable stem cell donor. It works by comparing the proteins on the surface of a child's blood cells with the proteins on a potential donor's cells. The more HLA (human leukocyte antigen) markers a child and donor share, the greater the chance that a transplant will be successful.

Treatment

Chemotherapy (the use of drugs to kill cancer cells) may be used to temporarily control JMML. However, effective treatment of JMML usually requires a stem cell (bone marrow) transplant.

This procedure involves destroying cancer cells and normal bone marrow and immune system cells with high-dose chemotherapy and then re-introducing healthy donor stem cells into the body. The new stem cells can rebuild a healthy blood supply and immune system.

Even though these therapies are the treatment of choice for kids with JMML, the disease remains difficult to cure. Researchers are looking into the use of alternative treatments, like molecular-targeted therapies (medicines that slow the growth of cancer cells by blocking certain molecules or proteins that help cancer cells grow) and immunotherapies (medicines that mark cancer cells so that the body's immune system can find the cells and remove them from the body).

Coping

Being told that your child has cancer can be very frightening, and the stress of treating the disease can be overwhelming for any family.

Although you might feel like it at times, you're not alone. To find support for you or your child, talk to your doctor or a hospital social worker. Many resources can help you get through this difficult time.

Reviewed by: Emi H. Caywood, MD
Date reviewed: June 2015



Related Resources

Web SiteCureSearch for Children's Cancer CureSearch for Children's Cancer supports and sponsors research and treatment for childhood cancers.
OrganizationAmerican Cancer Society The American Cancer Society is the nationwide community-based voluntary health organization dedicated to preventing cancer, saving lives and diminishing suffering from cancer through research, education, advocacy, and service. Call:(800) ACS-2345
OrganizationNational Marrow Donor Program (NMDP) The NMDP is a nonprofit organization that facilitates unrelated marrow and blood stem cell transplants for people with life-threatening diseases who do not have matching donors in their families.
Web SiteAlex's Lemonade Stand Foundation for Childhood Cancer A unique foundation that evolved from a young cancer patient's front-yard lemonade stand to a nationwide fundraising movement to find a cure for pediatric cancer.
OrganizationLeukemia & Lymphoma Society The Leukemia & Lymphoma Society is dedicated to funding blood-cancer research, education, and patient services. The Society's mission is to cure leukemia, lymphoma, Hodgkin's disease, and myeloma, and to improve the quality of life of patients and their families. Call: (914) 949-5213


Related Articles

Neutropenia Certain cancers, or cancer treatment, can weaken the immune system, requiring a child to stay home to avoid exposure to germs. Here are ways to help your child make the best of it.
Chronic Myelogenous Leukemia (CML) While this type of blood cancer is more common in adults, it affects children, too. Thanks to advances in therapy, most kids with CML can be cured.
Acute Lymphoblastic Leukemia (ALL) ALL is the most common type of leukemia, affecting nearly 75% of kids who have this cancer of the blood cells. With treatment, most recover.
Coping With Your Child's Cancer: Liz Scott's Story Liz discusses how her family dealt with her daughter Alex's cancer, and tells the inspiring story that led them to raise money for cancer research through Alex's Lemonade Stand Foundation for Childhood Cancer Research.
Side Effects of Chemotherapy and Radiation Side effects of cancer treatment can include fatigue or flu-like symptoms, hair loss, and blood clotting problems. After treatment ends, most side effects gradually go away.
Chemotherapy Chemotherapy medications are used to treat cancer throughout the body by killing actively dividing cells. Learn more about chemo.
Leukemia Leukemia refers to cancers of the white blood cells (also called leukocytes or WBCs). With the proper treatment, the outlook for kids who are diagnosed with leukemia is quite good.
Stem Cell Transplants Stem cells help rebuild a weakened immune system. Stem cell transplants are effective treatments for a wide range of diseases, including cancer.
Caring for a Seriously Ill Child Taking care of a chronically ill child is one of the most draining and difficult tasks a parent can face. But support groups, social workers, and family friends often can help.
Acute Myeloid Leukemia (AML) Among kids with leukemia, 20% have this form of the blood cancer. With treatment, most recover.
Cancer Center From treatments and prevention to coping with the emotional aspects of cancer, the Cancer Center provides comprehensive information that parents need.




Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

© 1995-2016 KidsHealth® All rights reserved.
Images provided by iStock, Getty Images, Corbis, Veer, Science Photo Library, Science Source Images, Shutterstock, and Clipart.com



 

Upcoming Events

We are driven by our values of safety, compassion, ownership, collaboration, innovation and value creation. We are looking for individuals to join our team who embody these values and support our mission of improving the health status of all kids in our region. We hope that might be you! Come to our job fair to learn more about our open opportunities.

Car Seat Safety Check

View full event calendarView more events...

Health and Safety

Your child's health and safety is our top priority

Accreditations

The Children's Medical Center of Dayton Dayton Children's
The Right Care for the Right Reasons

One Children's Plaza - Dayton, Ohio - 45404-1815
937-641-3000
www.childrensdayton.org