An infant with hepatocellular jaundice due to Langerhans cell histiocytosis was treated and responded well to intravenous etoposide. Pharmacokinetics demonstrated similar clearance and AUC data in both the jaundiced and non-jaundiced states but myelosuppression was greater when the infant was jaundiced. Children with hepatocellular jaundice require dose reductions of etoposide, despite the similar drag pharmacokinetics to the non-jaundiced state. The mechanisms involved are discussed.