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Central nervous system (CNS) relapse is a principal cause of treatment failure among patients with acute lymphoblastic leukemia (ALL). Isolated CNS relapse occurs in approximately 3%–8% of children with leukemia and accounts for 30%–40% of initial relapses in some clinical trials.[1][1]

The central nervous system microenvironment influences the leukemia transcriptome and enhances leukemia chemo-resistance