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The challenge of obesity in paediatric leukaemia treatment: it is not just size that matters
  1. Jaszianne Tolbert1,2,
  2. Gregory L Kearns1,3
  1. 1Department of Pediatrics and Pharmacology, University of Missouri Kansas City, Kansas City, Missouri, USA
  2. 2Divisions of Hematology/Oncology, Clinical Pharmacology, Medical Toxicology and Therapeutic Innovation, The Children's Mercy Hospital, Kansas City, Missouri
  3. 3Center for Children's Healthy Lifestyles and Nutrition, The Children's Mercy Hospital, Kansas City, Missouri, USA
  1. Correspondence to Dr Gregory L Kearns, The Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA; gkearns{at}


In the last two decades, tremendous advances have been made in the treatment of acute lymphocytic leukaemia (ALL) in children with 5 year ‘cure’ rates in excess of 90%. The maintenance of remission is due, in part, to individualisation of therapy which must consider age, body size, genetic constitution and the impact of disease on drug disposition and action. This review, focused on treatment of ALL and one of the therapeutic mainstays, 6-mercaptopurine, illustrates the importance of obesity as a modulating factor in dose individualisation.

  • Obesity
  • Childhood Leukemia
  • Drug Dosing

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