Low-dose conventional chemotherapy:  Studies have shown no influence from low-dose conventional chemotherapy on JMML patients’ length of survival. Some combinations of 6-mercaptopurine with other chemotherapy drugs have produced results such as decrease in organ size and increase or normalization of platelet and leukocyte count. Intensive chemotherapy:  Complete remission with ongoing durability from JMML has not been possible through use of intensive chemotherapy, but it is still used at times because it has improved the condition of a small but significant number of JMML patients who do not display an aggressive disease. The COG JMML study administers 2 cycles of fludarabine and cytarabine for 5 consecutive days along with 13-cis retinoic acid during and afterwards. The EWOG-MDS JMML study, however, does not recommend intensive chemotherapy before bone marrow transplant. 13-cis retinoic acid (Isotretinoin):  In the lab, 13-cis-retinoic acid has inhibited the growth of JMML cells. The COG JMML study therefore includes 13-cis-retinoic acid in its treatment protocol, though its therapeutic value for JMML remains controversial. Radiation
Radiation to the spleen does not generally result in a decrease in spleen size or reduction of platelet transfusion requirement. Stem cell transplantation
The only treatment that has resulted in cures for JMML is stem cell transplantation, also known as a bone marrow transplant, with about a 50% survival rate. The risk of relapsing after transplant is high, and has been recorded as high as 50%. Generally, JMML clinical researchers recommend that a patient have a bone marrow transplant scheduled as soon as possible after diagnosis.
Notable cases
Tony Bland – first patient in English legal history to be allowed to die
Paul Brophy – first American to die after court-authorization
Sunny von Bülow – lived almost 28 years in a persistent vegetative state until her death
Gustavo Cerati – Argentine singer-songwriter, composer and producer who died after four years in a coma
Prichard Colón – Puerto Rican former professional boxer and gold medal winner who spent years in a vegetative state after a bout
Nancy Cruzan – American woman involved in a landmark United States Supreme Court case
Gary Dockery – American police officer who entered, emerged and later reentered a persistent vegetative state
Eluana Englaro – Italian woman from Lecco whose life was ended after a legal case after spending 17 years in a vegetative state
Elaine Esposito – American woman who was a previous record holder for having spent 37 years in a coma
Lia Lee – Hmong person who spent 26 years in a vegetative state and was the subject of a 1997 book by Anne Fadiman
Martin Pistorius South African man who is a rare example of a survivor as his state progressed to minimally conscious after 3 years, locked in syndrome after another 4 more years, and fully came out of a coma after another 5 years. He is now a web designer, developer, and author. In 2011, he wrote a book called Ghost Boy, in which he describes his many years of being comatose.