What is intrathecal chemotherapy and why is it used in BPDCN? So BPDCN is a rare disease and really even in the recent years we've learned more about this diagnosis as it was understood in patients who are getting correct diagnoses. As we've gotten better at treating BPDCN, fortunately our patients are doing well and living longer with this condition and it's allowed us to recognize some unusual features of this disease. What was recognized is that the central nervous system or the fluid that bathes the brain and spinal cord can be involved with BPDCN and when patients live long enough if this area is not treated that can become symptomatic. So what we have started to recommend is that all patients have that area assessed, meaning checked sometime early in treatment by doing a lumbar puncture and sending that fluid to the lab to look for BPDCN and then in addition to checking to see if it's there, making sure that all patients get treatment to that area. So instilling chemotherapy into the space that bathes the spinal cord and the brain that's called the thecal space and so intrathecal means really putting chemotherapy directly in that area and killing off any BPDCN cells that are visible or might be there at a microscopic level to prevent them from growing and causing problems. So this is called central nervous system prophylaxis or CNS prophylaxis. We're very experienced with how to do this for another disease called ALL or acute lymphoblastic leukemia and so we're bringing the principles of that management over to BPDCN and saying this aspect of BPDCN is like ALL. We need to assess and treat that routinely for our patients.
HealthTree • January 22, 2026