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NCCN Guidelines for Patients



Acute Lymphoblastic Leukemia, Version 1.2017


Testing for ALL

Spinal fluid test

Figure 7

Lumbar puncture

Doctors perform a lumbar

puncture to remove a

sample of spinal fluid to

test for leukemia cells. A

lumbar puncture may also

be used to give liquids

such as drug treatments.

When drugs are injected

into the spinal fluid, it

is called IT (intrathecal)


Spinal fluid test

ALL can spread to the fluid around your brain and

spinal cord. This is called cerebrospinal fluid or spinal

fluid. To determine whether or not cancer is in spinal

fluid, a sample must be removed and tested.

A lumbar puncture is a procedure that is used to

remove spinal fluid. It is also called a spinal tap.

A lumbar puncture is often done when ALL is first

diagnosed. But, it may be done at a later time that fits

with your treatment plan. A lumbar puncture can also

be used to inject cancer drugs into the spinal fluid.

During this test, you will be lying down or sitting on

an exam table as shown in

Figure 7


If lying down, your knees will be tucked up near your

chest. If sitting, you will lean slightly forward and

down over your knees.

Local anesthesia will be used to numb the lower part

of your back over your spine. Next, a thin needle will

be inserted between the bones of your spine and

into the space around your spinal cord. The needle

will be used to take a sample of spinal fluid. You may

feel some pressure during the procedure. The fluid

sample will then be sent to a lab for testing for the

presence of leukemia cells.

Illustration Copyright © 2017 Nucleus Medical Media, All rights reserved.