Surgery for acute lymphocytic leukemia

Surgery has a very limited role in the treatment of acute lymphocytic leukemia (ALL). Because leukemia cells spread widely throughout the bone marrow and to many other organs through the blood, it is not possible to cure this type of cancer by surgery. Aside from a possible lymph node biopsy, surgery rarely has any role even in the diagnosis of ALL, since a bone marrow aspirate and biopsy can usually diagnose leukemia.

Often before chemotherapy is about to start, surgery is needed to insert a small plastic tube, called a central venous catheter or venous access device (VAD), into a large vein. The end of the tube stays just under the skin or sticks out in the chest area or upper arm. The VAD is left in place during treatment to give intravenous (IV) drugs such as chemotherapy and to take blood samples. This lowers the number of needle sticks needed during treatment. It is very important to learn how to care for the device to keep it from getting infected.