A spinal tap was ordered to see if the leukemic cells had crossed the blood/brain barrier.  There were many lymphoblasts in the spinal fluid. In ALL the leukemic cells are often harbored in the meninges.

Video of lumbar puncture on a child with leukemia

Noah was started on chemotherapy which would kill as many of the cancer cells as possible. He was also given a  transfusion of 2 units of packed red blood cells to help alleviate his anemic condition. Noah was released from the hospital but continued chemotherapy treatments weekly. After 3 weeks of chemotherapy treatments, Noah developed a fever of 102°F. Examination revealed coarse breath sounds in the right anterior chest. An order was sent to the radiology technician for a series of chest radiographs.