Therapeutic drug monitoring-guided dosing of busulfan differs from weight-based dosing in hematopoietic stem cell transplant patients

Busulfan (Bu)-based preparative regimens in hematopoietic stem cell transplantation are commonly used. Previous studies have shown that Bu at a fixed dose of 3.2mg/kg/day (FBD) given intravenously decreases variability in drug pharmacokinetics and this decreases the dependency on therapeutic drug mo...

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Published in:Hematology/oncology and stem cell therapy 2017-06, Vol.10 (2), p.70-78
Main Authors: Salman, Bushra, Al-Za'abi, Mohammed, Al-Huneini, Mohammed, Dennison, David, Al-Rawas, Abdulhakeem, Al-Kindi, Salam, Al-Farsi, Khalil, Tauro, Melanie, Al-Khabori, Murtadha
Format: Article
Language:English
Subjects:
Adolescent
Adult
Busulfan
Busulfan - pharmacokinetics
Busulfan - therapeutic use
Child
Child, Preschool
Drug monitoring
Drug Monitoring - methods
Female
Hematopoietic stem cell transplantation
Hematopoietic Stem Cell Transplantation - methods
Humans
Male
Middle Aged
Pharmacokinetics
Retrospective Studies
Transplantation Conditioning - methods
Young Adult
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Summary:Busulfan (Bu)-based preparative regimens in hematopoietic stem cell transplantation are commonly used. Previous studies have shown that Bu at a fixed dose of 3.2mg/kg/day (FBD) given intravenously decreases variability in drug pharmacokinetics and this decreases the dependency on therapeutic drug monitoring (TDM) of Bu. We compared the Bu dose given using TDM with the FBD of 3.2mg/kg/day. Seventy-three patients with acute leukemia, myelodysplasia, chronic myeloid leukemia, thalassemia major, and sickle cell disease were included. The mean age at transplant was 15years (range 2–55years) with 57% adults. Indication for transplantation was leukemia/myelodysplastic syndrome in 46% of the patients, while the remaining 54% were transplanted for inherited blood disorders. We found that the median FBD was lower than the median TDM dose by 39mg/day with a statistically significant difference (p
ISSN:1658-3876
DOI:10.1016/j.hemonc.2017.03.003