Intrathecal Therapy for Leukemia in Children

In acute childhood leukemias, cancer cells can spread to the central nervous system, which includes the brain and spinal cord. Chemotherapy drugs administered by mouth and through a vein with intravenous (IV) infusion cannot eliminate these cancer cells, because the drugs are unable to pass through the body’s blood–brain barrier. This barrier consists of a network of protective tissue that prevents certain substances—such as hormones, foreign substances (such as medications), and other components of the blood—from entering the brain.

In children with acute lymphoblastic leukemia and acute myeloid leukemia, doctors at Hassenfeld Children’s Hospital at NYU Langone administer targeted chemotherapy drugs during a lumbar puncture to not only kill any cancer cells in the brain and spinal cord but also to prevent new cancer cells from forming. During this procedure, your child’s doctor inserts a small needle into the lower back to administer the medication directly into the cerebrospinal fluid that surrounds the brain and spinal cord. A lumbar puncture is performed in the hospital and requires anesthesia. Your child can usually go home the same day.

During chemotherapy treatment for childhood acute lymphoblastic leukemia, which can last two to three years, numerous intrathecal therapy treatments may be needed. These occur most frequently during the first six months of treatment. Chemotherapy for childhood acute myeloid leukemia usually lasts up to six months, so children with this condition receive fewer intrathecal therapy treatments.