Leukemia is a cancer of blood cells. And blood cells travel throughout the body. Therefore leukemia is never managed with surgery, which is a treatment for a localized disease, or a disease that is in one place. Stem cell transplant is occasionally used to treat the most aggressive leukemias or leukemias that have come back after standard chemotherapy. Again, this is a potentially high-risk procedure that involves treating a patient with aggressive chemotherapy to not only limit the amount of leukemia, but also to get rid of the patient’s immune system. Afterward, a donor’s immune system is introduced and hopefully the new immune system can fight the remaining leukemia cells. This therapy is associated with a high risk of complications, but in some cases offers the best chance of a cure.