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Acute lymphocytic leukemia cells often collect in the lining of the spinal cord and brain, called the meninges. If not treated, the meninges can harbor leukemia cells, and relapse can occur in this site (meningeal leukemia). For this reason, treatment is also directed to those sites by injecting drugs, like methotrexate, into the spinal column, or irradiating the covering of the central nervous system using an X-ray treatment machine. Sometimes both forms of treatment are used. These areas of the body, which are less accessible to chemotherapy when given by mouth or in the vein, have been referred to as sanctuary sites. en34
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