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In childhood non-Hodgkin lymphoma, cancer cells can spread to the brain and the spinal cord, which make up the central nervous system. Chemotherapy can’t eliminate these cancer cells, because the drugs are unable to pass through the body’s blood–brain barrier. This network of protective tissue prevents substances that can be harmful—certain hormones, medications, and bacteria—from entering the brain.

To destroy cancer cells and prevent new ones from forming in the central nervous system, our doctors use a lumbar puncture to administer targeted chemotherapy drugs directly into the cerebrospinal fluid that surrounds the brain and spinal cord. In this procedure, performed in the hospital under sedation, the doctor inserts a small needle into the lower back. Your child can usually go home the same day.

During chemotherapy treatment for lymphoblastic lymphoma, which can last two to three years, up to 20 intrathecal therapy treatments may be needed. Fewer treatments are needed for other types of childhood non-Hodgkin lymphoma, for which treatment typically lasts up to six months.