HOW IS ALL TREATED?
Children with ALL need to be treated as soon as possible after being diagnosed. The type of treatment is determined by your child’s risk group and may include chemotherapy, radiation, bone marrow transplant (stem cell transplant), and/or CAR T-cell therapy. VENOUS ACCESS DEVICE (VAD) A venous access device (VAD), sometimes called a central venous catheter or central line, is a temporary or long- term intravenous (IV) tube that can be used for the duration of your child’s therapy (keep in mind that “therapy” can be used interchangeably with “treatment”). It is placed in a large vein in the chest or the arm. These long, flexible catheters empty into or near the heart, allowing necessary treatments to be given within seconds. They can be used to administer medications, fluids, chemotherapy, blood products, and nutritional support as needed and to draw blood for testing. A surgery is performed to insert the VAD, and your child will be sedated or given general anesthesia for the procedure. It will be placed either before chemotherapy begins or within the first month of treatment. Not all children will need a VAD. This will be determined by you and your child’s healthcare team. The VAD will be removed when it is no longer needed. There are different types of VADs, such as an implanted port inserted under the skin near the collarbone; a tunneled central venous catheter (Broviac or Hickman) that has a tube; a lumen (either single or double) which comes out of your child’s chest; or a PICC (peripherally inserted central catheter) line, a central line inserted through a vein in the arm. Your child’s healthcare team will discuss each type with you and help you choose the best device for your child’s treatment. Each type of catheter requires slightly different care. A port requires almost no care at home, but a special needle will need to be inserted through the skin into the port each time it is used. Tubing can then be attached to the needle if needed to give medication or IV fluids. An external central line requires routine changes to the dressing that covers the exit site of the line and keeps it in place to prevent infection and to care for the skin around the tube. The external lines also must be routinely flushed with a solution to keep them working properly. You will be taught how to care for the device at home.
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