All of us send best wishes to your child and your friend's child, Justin. It is a very difficult disease for the kids.
The bone marrow biopsy (BMB) report enables diagnosis, and shows whether there are multiple chromosome translocations (mutations). I will assume Justin was diagnosed properly. Ph+ AML can be tricky to diagnose as separate from CML in some cases, so a second opinion would be a very good idea. If it were my child, I would contact Dr Brian Druker by email or have his Onc do it himself and ask Dr Druker if he would review the BMB report. I strongly urge a second opinion on this issue -- the diagnosis of Ph+ AML is not as easy as one might assume.
I will provide some basic information here dealing with the issue in general.
Philadelphia Chromosome positive Acute Myeloid Leukemia (Ph+ AML) is related to CML in that both forms of leukemia have the Philadelphia Chromosome which creates genetic signals causing uncontrolled growth of leukemic white blood cells. As the names imply, CML and AML are predominately diseases of the myeloid line (neutrophils, etc) of white blood cells (WBCs). Beyond that, the "chronic" (CML) is generally a less aggressive form than the "acute" (AML) form. For CML, 3 drugs are available which work for over 90% of all CML cases.
Since Ph+ AML is generally a more aggressive form of leukemia than CML, it often does not respond very well or very long to CML drugs (Gleevec, Tasigna, and Sprycel). But there are some cases where the drugs have helped, especially in getting the patient into a state where they are in better shape for a bone marrow transplant. In general, Ph+ AML usually results in the need for a stem cell transplant since it is more likely to become resistant to the drugs than CML. So Ph+ AML drug response is often short-lived. Sprycel may have the best chance of working of the 3 drugs, but there is not much data, especially for children.
The Onc will be trying to first put Justin into a stronger state to better withstand a bone marrow transplant. This will be done using chemotherapy (induction phase). A CML drug may or may not be used during or after the chemotherapy. This should be a question to ask the Onc. If Justin becomes stronger and a suitable donor can be found, it is very likely the Onc would want to proceed with a transplant while Justin is in a stronger state, since that strength can often be lost over time. The initial chemotherapy will not cure him, so there will need to be a longer term plan. The only long term solution would be either CML drug therapy (questionable chance of long term success) or transplant (assuming a suitable donor).
Questions for the Onc:
1) Will a "CML drug" be used? If so, when? If not, why not?
2) What is the treatment plan and sequence of events? After the initial chemo, what happens and when?
3) Is a transplant being planned? If so, when will the donor search process start?
4) Would the Onc contact Dr Druker at Oregon Health & Science University about the case?
Here is some reading (somewhat difficult to understand):
Let me know if I can help further. We wish Justin the very best.