The Role of Therapeutic Drug Monitoring in the Treatment of Childhood Leukemia.

Therapeutic drug monitoring (TDM) is critical for optimizing chemotherapy in pediatric leukemia, where high interpatient variability and narrow therapeutic windows increase the risk of toxicity. This review examines TDM for key cytotoxic agents as well as tyrosine kinase inhibitors. TDM enables individualized dosing, guides supportive care decisions, facilitates adherence monitoring, and minimizes treatment-related adverse effects. Advances in TDM may enable clinicians to incorporate real-time monitoring, predictive modeling, and standardized guidelines into clinical decision making to achieve safe and effective leukemia treatment in children.