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Intravenous Busulfan: A Guide to Its Use as Conditioning Treatment before Transplantation of Haematopoietic Progenitor Cells

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Abstract

With intravenous administration of busulfan (Busilvex®), the therapeutic range of the drug is achieved in more paediatric patients than after oral busulfan administration. In clinical trials in paediatric and adult patients, intravenous busulfan-based preconditioning treatment regimen prior to haematopoietic progenitor cell transplantation (HPCT) provided high rates of engraftment, low transplant-related mortality rates and good overall survival and progression-free survival outcomes. Intravenous busulfan was considered to have an acceptable tolerability profile.

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References

  1. Fisher VL, Barnes YJ, Nuss SL. Pretransplant conditioning in adults and children: dose assurance with intravenous busulfan. Oncol Nurs Forum 2006 Mar; 33(2): E36–43

    Article  PubMed  Google Scholar 

  2. Léger CS, Nevill TJ. Hematopoietic stem cell transplantation: a primer for the primary care physician. CMAJ 2004 May 11; 170(10): 1569–77

    PubMed  Google Scholar 

  3. Busilvex: European Public Assessment Report. London: European Medicines Agency, 2012 Mar 27

  4. Buggia L, Locatelli F, Regazzi M-B, et al. Busulfan. Ann Pharmacother 1994; 28(9): 1055–62

    PubMed  CAS  Google Scholar 

  5. Busilvex: summary of product characteristics. London: European Medicines Agency, 2012 Mar 27

  6. Vassal G, Michel G, Esperou H, et al. Prospective validation of a novel IV busulfan fixed dosing for paediatric patients to improve therapeutic AUC targeting without drug monitoring. Cancer Chemother Pharmacol 2008; 61: 113–23

    Article  PubMed  CAS  Google Scholar 

  7. Wall DA, Chan KW, Nieder ML, et al. Safety, efficacy, and pharmacokinetics of intravenous busulfan in children undergoing allogenic hematopoietic stem cell transplantation. Pediatr Blood Cancer 2010; 54(2): 291–8

    PubMed  Google Scholar 

  8. Michel G, Valteau-Couanet D, Gentet J-C, et al. Weight-based strategy of dose administration in children using intravenous busulfan: clinical and pharmacokinetic results. Pediatr Blood Cancer 2012; 58(1): 90–7

    Article  PubMed  Google Scholar 

  9. Lemaistre JA, Bachier C, Smith B, et al. Once daily busulfan cyclophosphamide regimen is well tolerated and effective as a preparative regimen for allogenic hematopoietic stem cell transplant. J Oncol Pharm Pract 2012; 18(1): 17–22

    Article  PubMed  Google Scholar 

  10. Tang W, Wang L, Zhao WL, et al. Intravenous busulfan-cyclophosphamide as a preparative regimen before allogenic hematopoietic stem cell transplantation for adult patients with acute lymphoblastic leukemia. Biol Blood Marrow Transplant 2011; 17(10): 1555–61

    Article  PubMed  CAS  Google Scholar 

  11. Escalón MP, Stefanovic A, Venkatraman A, et al. Autologous transplantation for relapsed non-Hodgkin’s lym-phoma using intravenous busulfan and cyclophosphamide as conditioning regimen: a single center experience. Bone Marrow Transplant 2009; 44(2): 89–96

    Article  PubMed  Google Scholar 

  12. Sobecks RM, Rybicki L, Yurch M, et al. Intravenous compared with oral busulfan as preparation for allogenic hematopoietic progenitor cell transplantation for AML and MDS. Bone Marrow Transplant 2011. Epub 2011 Aug 29

  13. Michel G, Valteau-Counanet, D, Esperou, H. A new I.V. busulfan fixed dosing for conditioning before autologous or allogeneic hematopoietic stem cell transplantation in children with malignant and non-malignant diseases: pharmacokinetics, toxicity and clinical outcomes [abstract no. 1758]. Blood 2005; 106(11 Pt 1): 500a. Plus poster presented at the 47th Annual Meeting of the American Society of Hematology; 2005 Dec 10–13; Atlanta (GA)

    Google Scholar 

  14. Vassal G, Koscielny S, Challine D, et al. Busulfan disposition and hepatic veno-occlusive disease in children undergoing bone marrow transplantation. Cancer Chemother Pharmacol 1996; 37(3): 247–53

    Article  PubMed  CAS  Google Scholar 

  15. Hassan M. The role of busulfan in bone marrow transplantation. Med Oncol 1999; 16(3): 166–76

    Article  PubMed  CAS  Google Scholar 

  16. Lee JL, Gooley T, Bensinger W, et al. Veno-occlusive disease of the liver after busulfan, melphalan, and thiotepa conditioning therapy: incidence, risk factors, and outcome. Biol Blood Marrow Transplant 1999; 5(5): 306–15

    Article  PubMed  CAS  Google Scholar 

  17. Hempel G, Oechtering D, Lanvers-Kaminsky C, et al. Cyto-toxicity of dimethylacetamide and pharmacokinetics in children receiving intravenous busulfan. J Clin Oncol 2007 May 1; 25(13): 1772–8

    Article  PubMed  CAS  Google Scholar 

  18. Paci A, Vassal G, Moshous D, et al. Pharmacokinetic behavior and appraisal of intravenous busulfan dosing in infants and older children: the results of a population pharmacokinetic study from a large pediatric cohort undergoing hematopoietic stem-cell transplantation. Ther Drug Monit 2012 Apr; 34(2): 198–208

    Article  PubMed  CAS  Google Scholar 

  19. de Lima M, Couriel D, Thall PF, et al. Once-daily intravenous busulfan and fludarabine: clinical and pharmacokinetic results of a myeloablative, reduced-toxicity conditioning regimen for allogeneic stem cell transplantation in AML and MDS. Blood 2004 Aug 1; 104(3): 857–64

    Article  PubMed  Google Scholar 

  20. González-Vicent M, Molina B, Pérez A, et al. Once-daily intravenous busulfan for 47 pediatric patients undergoing autologous hematopoietic stem cell transplantation: a single center study. J Pediatr Hematol Oncol 2012 Apr; 34(3): 180–3

    Article  PubMed  Google Scholar 

  21. Russell JA, Tran HT, Quinlan D, et al. Once-daily intravenous busulfan given with fludarabine as conditioning for allogeneic stem cell transplantation: study of pharmacokinetics and early clinical outcomes. Biol Blood Marrow Transplant 2002; 8(9): 468–76

    Article  PubMed  CAS  Google Scholar 

  22. Madden T, de Lima M, Thapar N, et al. Pharmacokinetics of once-daily IV busulfan as part of pretransplantation preparative regimens: a comparison with an every 6-hour dosing schedule. Biol Blood Marrow Transplant 2007 Jan; 13(1): 56–64

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements and Disclosures

This article was reviewed by G. Hempel, Westfälische Wilhelms-Universität Münster Institut für Pharmazeutische und Medizinische, Münster, Germany.

The preparation of this article was not supported by any external funding. During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on the article. Changes resulting from comments received were made by the authors on the basis of scientific and editorial merit.

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Correspondence to Lesley J. Scott.

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Scott, L.J., Hoy, S.M. & Lyseng-Williamson, K.A. Intravenous Busulfan: A Guide to Its Use as Conditioning Treatment before Transplantation of Haematopoietic Progenitor Cells. Clin Drug Investig 32, 641–648 (2012). https://doi.org/10.1007/BF03261918

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