In oncology, a sanctuary site refers to a specific location in the body where leukemia cells can “hide” or persist because standard systemic chemotherapy cannot reach them in effective concentrations.
The most common sanctuary sites include:
- Central Nervous System (CNS): This is the most frequent sanctuary site because the blood-brain barrier prevents many systemic chemotherapy agents from crossing into the spinal fluid at the dose-intensity required to kill cancer cells.
- Testes: Historically, this site required longer maintenance therapy in males to prevent relapse.
- Eyes (Ocular involvement): Similar to the CNS, the eyes are often shielded from systemic drugs.
Because these areas are protected, specialized treatments—such as intrathecal chemotherapy (injected directly into the spinal fluid) or high-dose systemic agents that can cross the blood-brain barrier—are mandatory components of treatment to prevent relapse.
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