Emma Thomas

Leukaemia is the most common childhood cancer and although therapeutic advances have led to an increase in cure rates over the past 40 years, cure rates remain poor for children in high-risk groups, and even worse for those who relapse. Treatment for ALL involves a multi-drug regimen and despite these drugs being used clinically for many years, little work has been done to investigate their pharmacokinetics. 50-70% of children will experience grade 3 and 4 toxicities; these almost always require additional hospitalisations and use of adjunctive therapies. As well as the patient health implications, the occurrence of severe toxicity has a significant social impact on patients and their families. It is therefore necessary to research and understand the cause of these toxic effects which may lead to improvement of current practice to better detect, monitor, and manage these toxicities. Currently, the degree of variation in plasma drug levels amongst children and whether this correlates with their clinical outcomes is largely unknown. My work is directly addressing this by conducting a clinical study to assess the variability in plasma drug levels in paediatric leukaemia patients and to determine whether their exposure levels correlate with clinical outcomes such as toxicities, efficacy, and survival.