Cyclophosphamide Busulfan

The optimal myeloablative preparative regimen is challenging to study because several indications for HCT (e.g., SCID and thalassemia) are rare enough that it is not feasible or is cost-prohibitive to conduct clinical trials that are powered adequately to detect clinically relevant differences. The longterm outcomes of busulfan-cyclophosphamide (BU-CY) and... 

Ferry C, Socie G. 2003. Busulfan-cyclophosphamide versus total body irradiation-cyclophosphamide as preparative regimen before allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia What have we learned Exp Hematol. 31 1182-1186. 

BUSULFAN CYCLOPHOSPHAMIDE t incidence of veno-ocdusive disease and mucositis when cyclophosphamide is given <24 hours after the last dose of busulfan. Possibly also 1 effect of cyclophosphamide There is l clearance and T elimination half-life of cyclophosphamide, and T concentrations of the active metabolite 4-hydroxycydophosphamide Administer cyclophosphamide at least 24 hours after the last dose of busulfan... 

In 66 patients who received busulfan in combination with cyclophosphamide, etoposide, and/or cytarabine in preparation for bone marrow transplantation, there was a higher incidence of veno-occlusive disease of the liver (sinusoidal obstruction syndrome) in those who received busulfan + cyclophosphamide (four of 10) than in those who received busulfan + cyclophosphamide + cytarabine (one of 18) or busulfan + cyclophosphamide + etoposide (seven of 38) (24). The risk of veno-occlusive disease was higher in those whose busulfan AUC was over 1500 minute.pmol/l (relative risk = 11). Other pharmacokinetic parameters, age, sex, type of bone marrow transplantation, previous therapy, or pretransplant liver function tests were not predictive of veno-occlusive disease. 

Chopra R, Goldstone AH, McMillan AK, et al. Successful treatment of acute myeloid leukemia beyond first remission with autologous bone marrow transplantation using busulfan/cyclophosphamide and unpurged marrow The British autograft group experience. J Qin Oncol 1991 9 1840-1847. 

Kashyap A, Wingard J, Cagnoni P, et al. Intravenous versus oral busulfan as part of a busulfan/cyclophosphamide preparative regimen for allogeneic hematopoietic stem cell transplantation decreased incidence of hepatic venoocclusive disease (HVOD), HVOD-related mortality, and overall 100-day mortality. Biol Blood Marrow Transplant 2002 8 493-500. 

A man well stabilised on warfarin had a marked reduction in his anticoagulant response on two occasions while taking mercaptopurine, but no changes occurred when he took busulfan, cyclophosphamide, cytarab-ine, hydroxycarbamide, mitobronitol, demecolcine or melphalan. A woman needed a marked increase in her dosage of acenocoumarol, from 21 to 70 mg weekly, when she was given mercaptopurine 100 mg daily. Another patient required about a 25% increase in warfarin dose while taking mercaptopurine 1(X) mg daily. 

The MEPS technique has been used to extract a wide range of analytes in different matrices (urine, plasma, blood). Several drugs such as local anesthetics and their metabolites, the anticancer dmgs roscovitine, olomoucine, busulfan, cyclophosphamide, 3-blockers acebutolol and metoprolol, the neurotransmitters dopamine and serotonin, methadone, and cocaine and cocaine metabolites have been extracted from biological samples such as blood, plasma, and urine using MEPS. ... 

Bleomycin, busulfan, carmustine, cyclophosphamide, methotrexate, mitomycin, and radiation therapy... 

Despite the fact that alkylating agents exhibit a common mechanism of action, their clinical use varies depending on differences in pharmacokinetics, metabolism, hpid solubility, ability to penetrate membranes, and toxicity. They can be classified as nitrogen-containing mustard derivatives (mechorethamine, chlorambucil, melfalan, cyclophosphamide, ifos-famide), derivatives of ethylenimine (thiotepa), nitrosoureas (carmustine, lomustine, strep-tozocin), alkylsulfonates (busulfan), and derivatives of platinum (cwplatin, carboplatin). 

Mechlorethamine Forms DNA cross-links, resulting in inhibition of DNA synthesis and function Hodgkin s and non-Hodgkin s lymphoma Nausea and vomiting Moderate depression of peripheral blood count excessive doses produce severe bone marrow depression with leukopenia, thrombocytopenia, and bleeding alopecia and hemorrhagic cystitis occasionally occur with cyclophosphamide cystitis can be prevented with adequate hydration busulfan is associated with skin pigmentation, pulmonary fibrosis, and adrenal... 

Socie G, Clift RA, Blaise D, Devergie A, et al. 2001. Busulfan plus cyclophosphamide compared with total-body irradiation plus cyclophosphamide before marrow transplantation for myeloid leukemia Long term followup of four randomized studies. Blood. 98 3569-3574. 

Polycythemia vera Busulfan, chlorambucil, or cyclophosphamide Radioactive phosphorus 32... 

Some toxicants are known to affect the female reproductive system and processes. Exposure to the alkylating agents cyclophosphamide and vincristine can lead to loss of female sexual function. Cyclophosphamide may attack and damage the oocytes, cells that lead to egg formation. Pharmaceutical busulfan damages ovaries. The 7,8-diol-9,10-epoxide of benzo(a)pyrene, as well as some other metabolites of polycyclic aromatic hydrocarbons, can be toxic to oocytes. 

Anticancer drags (e.g., cyclophosphamide, busulfan) Anticonvulsants (e.g., valproic acid)... 

CIMETIDINE BUSULFAN, CARMUSTINE, CHLORAMBUCIL CYCLOPHOSPHAMIDE, ESTRAMUSTINE, IFOS-FAMIDE, LOMUSTINE, THIOTEPA, TREOSULFAN T adverse effects of cytotoxic, e.g. myelosuppression Additive toxicity. Possible minor inhibition of cyclophosphamide metabolism via CYP2C9 Monitor more closely monitor FBC regularly. Avoid co-administration of cimetidine with cyclophosphamide... 

TEM (triethylenemelamine) Myleran or Busulfan (methanesulfonic acid, tetramethylene ester), antimitotic drugs such as Dichloren (me-chlorethamine hydrochloride) and Cytoxan (cyclophosphamide). X-rays, and steroid therapy show different effects without consistent results. The question must be further investigated. 

---