Is treatment in the spine common for treating pediatric AML?

Is treatment in the spine common for treating pediatric AML? One of the major turning points in the treatment of pediatric leukemia over the last 50 years is the development of central nervous system prophylaxis. When doctors first started figuring out how to treat children with leukemia, and again, that would be primarily ALL, not AML, but when they started figuring out how to treat those children, they were able to get children into remission, but then very, very commonly there would be relapses within the brain and the spinal cord. That's called the central nervous system. So what they realized is that we need to treat the central nervous system with chemotherapy up front to prevent a relapse in the brain. The reason for that is that the body is very smart and has protected the central nervous system with what's called the blood-brain barrier. That means that toxins and other bad things in the body should not be allowed to get into the central nervous system because otherwise your brain would be in danger. And the blood-brain barrier also protects the brain from some of our chemotherapy agents. So we give the chemotherapy agents into the blood. We treat all the leukemia that's in the bones and the blood, but the leukemia cells that are in the brain go untreated. And so for that reason, we provide what's called prophylaxis, which is preventative chemotherapy to the brain for children with leukemia.