Intravenous busulfan for allogeneic hematopoietic stem cell transplantation in infants: clinical and pharmacokinetic results

SUMMARY: High-dose busulfan is an important component of myeloablative regimens. Variable drug exposure may occur following oral administration. Therefore, the use of intravenous busulfan

has been advocated. Previous work has suggested a cumulative dosage of 16 mg/kg for haematopoietic transplantation in children less than 3 years of age, but only limited data are available

in infants. Pharmacokinetics of intravanous busulfan administered at the suggested dosage were studied in 14 infants (median age 4.7 months). Busulfan plasma concentrations were measured by

either GC-MS or HPLC-UV. In seven patients, the dose was decreased to target an area- under- the- curve of 600–1300 _μ_mol min. The median total dose given was 13.8 mg/kg. All patients

engrafted. Severe veno-occlusive disease occurred in one patient. Our study demonstrates that a cumulative dosage of 16 mg/kg is associated with higher exposure than expected in infants. We

suggest an initial dose of 0.8 mg/kg followed by pharmacokinetically guided dose adjustment. Access through your institution Buy or subscribe This is a preview of subscription content,

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Article  CAS  Google Scholar  Download references ACKNOWLEDGEMENTS JH Dalle is a fellow of La Fondation Charles Bruneau. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Service

d'Hématologie et Oncologie Pédiatrique, Hôpital Sainte Justine, Montréal, QC, Canada J H Dalle, Y Theoret, M Duval, D Larocque, M F Vachon & M A Champagne * Methodist

Children's Hospital of South Texas, San Antonio, TX, USA D Wall & C Taylor * Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center,

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permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Dalle, J., Wall, D., Theoret, Y. _et al._ Intravenous busulfan for allogeneic hematopoietic stem cell transplantation in infants: clinical

and pharmacokinetic results. _Bone Marrow Transplant_ 32, 647–651 (2003). https://doi.org/10.1038/sj.bmt.1704209 Download citation * Received: 18 December 2002 * Accepted: 17 March 2003 *

Published: 16 September 2003 * Issue Date: 01 October 2003 * DOI: https://doi.org/10.1038/sj.bmt.1704209 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this

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KEYWORDS * busulfan * infants * pharmacokinetics * allogeneic