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The challenge of obesity in paediatric leukaemia treatment: it is not just size that matters

Jaszianne Tolbert1, Gregory L Kearns2

  • 1Department of Pediatrics and Pharmacology, University of Missouri Kansas City, Kansas City, Missouri, USA Divisions of Hematology/Oncology, Clinical Pharmacology, Medical Toxicology and Therapeutic Innovation, The Children's Mercy Hospital, Kansas City, Missouri.

Archives of Disease in Childhood
|October 23, 2014
PubMed

Insights

Childhood acute lymphocytic leukaemia (ALL) treatment success relies on personalized therapy. Obesity significantly impacts the dosing of 6-mercaptopurine, a key drug in maintaining remission.

Area of Science:

  • Pediatric Oncology
  • Pharmacogenomics
  • Leukemia Research

Background:

  • Significant advances in childhood acute lymphocytic leukaemia (ALL) treatment have led to over 90% 5-year survival rates.
  • Therapeutic success in ALL is increasingly dependent on individualized treatment strategies.
  • 6-mercaptopurine is a cornerstone therapy for maintaining remission in ALL patients.

Purpose of the Study:

  • To review the role of 6-mercaptopurine in childhood ALL treatment.
  • To highlight the importance of obesity as a factor in individualizing 6-mercaptopurine dosage.
  • To emphasize the need for personalized dosing in ALL therapy.

Main Methods:

  • Literature review focused on childhood ALL treatment protocols.
  • Analysis of factors influencing drug disposition and action in ALL.
  • Examination of obesity's impact on 6-mercaptopurine pharmacokinetics and efficacy.

Main Results:

  • Individualized therapy, considering factors like age and genetics, is crucial for ALL remission maintenance.
  • Obesity significantly modulates the disposition and action of 6-mercaptopurine.
  • Dose adjustments for 6-mercaptopurine may be necessary in obese pediatric ALL patients.

Conclusions:

  • Personalized dosing of 6-mercaptopurine is essential for optimizing treatment outcomes in pediatric ALL.
  • Obesity represents a critical factor to consider in the individualization of ALL therapy.
  • Further research into obesity's role in ALL pharmacotherapy is warranted.

Keywords:
Childhood LeukemiaDrug DosingObesity

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