Written by a parent, not a doctor. Nothing here is medical advice.

Childhood Cancer Lantern
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Medicine

Prednisolone / prednisone

Updated September 2026.

Also known as: pred, prednisone

The milder steroid. Same job as dexamethasone: tells leukemia cells to shut themselves down.

Prednisone and prednisolone are the same medicine for practical purposes: the liver turns prednisone into prednisolone. Both are steroids in the same family as dexamethasone, usually given as a pill or a liquid.

They kill leukemia cells the same way dexamethasone does. The steroid locks onto a receptor inside the lymphoblast, the pair moves into the nucleus and changes which genes the cell reads, and the cell starts its own self-destruct program. Prednisolone is milder than dexamethasone dose for dose and clears the body faster. Which one a protocol uses at which point is a choice the study designers made; your roadmap says which one your child gets.

I made an everyday analogy and a more scientific visualization of prednisolone.

Everyday analogy

Prednisolone is like a letter that tells a shop to close.

Prednisolone is like a letter that tells a shop to close. A yellow-skinned shopkeeper works in an open bookshop. A blue postal car arrives. A yellow-skinned mail carrier opens the door, steps out, closes the door and walks to her with his mail bag. He takes out a teal letter and hands it to her. She opens it and lifts the instruction: Please close the shop. She reads, briefly looks surprised, then nods. She puts the same letter on the counter and pulls the shutter belt twice. The shutter lowers in response to each pull and stays closed. The view gently moves closer for the handoff, reading and belt pulls. The teal letter represents the medicine and the shutdown signal it can set in motion. The shop represents a leukemia cell. The shopkeeper following the letter represents the cell using its own machinery to activate its self-destruct process, not a temporary pause. This simplified scene shows a cell that responds to the medicine. AN EVERYDAY ANALOGY A letter that starts closing time OPEN CLOSED THE BOOKSHOP POST Pleaseclosethe shop. A mail carrier arrives with a teal letter for the shopkeeper. She opens the letter. It says, “Please close the shop.” She follows the instruction and closes the shop herself.

1 / 3 The instruction arrives

A mail carrier arrives with a teal letter for the shopkeeper.

  • The teal letter represents prednisolone and the shutdown signal it can set in motion.

  • The shop represents a leukemia cell. The shopkeeper following the letter represents the cell using its own machinery to shut itself down.

  • Closing the shop represents the cell’s self-destruct process, not a temporary pause. This simplified scene shows a leukemia cell that responds to the medicine.

Press play below for a more accurate visualization.

Interactive visual

How prednisolone reaches a leukemia cell, wakes its steroid receptor and changes which genes are read

Poster for How prednisolone reaches a leukemia cell, wakes its steroid receptor and changes which genes are read
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103-second visual. Molecules and timing are teaching-scale abstractions. ## 0–14s: From the gut to the working medicine 0s — Steroid medicine passes from the gut into blood. Prednisolone is already active; the liver can also make it from prednisone. 6s — Here in a liver cell, active prednisolone is ready to travel in blood. Prednisolone itself needs no activation. ## 14–29s: From blood through the cell membrane 14s — Blood delivers prednisolone to leukemia cells. Watch the same molecule approach the cell membrane. 19s — Prednisolone dissolves into the oily middle of the membrane, then emerges inside. It needs no transporter door. ## 29–49s: A receptor receives the signal 29s — Helper proteins keep the steroid receptor ready. Prednisolone approaches its binding pocket. 35s — As prednisolone settles into the pocket, the receptor changes shape and its helper proteins move away. 42s — This exposes a guidance tag. The activated receptor can now move toward the nucleus. ## 49–74s: Changing which genes are read 49s — The receptor crosses a nuclear pore to reach the DNA inside. The DNA sequence stays the same. 59s — Receptor partners bind beside a gene. A reading enzyme moves along DNA, making a separate message copy. 66s — The message is a temporary working copy. DNA stays intact; later, the cell uses the message to build proteins. ## 74–91s: The cell’s own death pathway 74s — The message reaches a protein maker. It builds death-signal proteins that move toward a mitochondrion. 80s — In leukemia cells that respond to steroids, these proteins encourage mitochondria to leak a signal. 85s — That leak wakes dormant enzymes called caspases. They dismantle the cell from inside. ## 91–103s: Sealed packets and cleanup 91s — The cell shrinks into many small sealed packets. A cleanup cell gathers and swallows them.

Side effects

The full list, kept up to date:

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