Busulfan for

Seizures have been reported in both adult and pediatric patients receiving high-dose busulfan for HCT preparative regimens. Anticonvulsants are used to minimize the risk of... 

A 49-year-old man with chronic myelogenous leukemia developed dense posterior subcapsular cataracts and punctate cortical opacities after taking busulfan for 5 years (15). Ultrastructural examination showed cortical liquefaction, with Morgagnian droplets involving primarily the region from the equator to the posterior subcapsular space, crystalloid rays, and abundant degenerate lens fiber membranes. 

A patient with polycythemia vera who had undergone splenectomy received six courses of busulfan for recurrent thrombocytosis over 19 years (22). Severe pancytopenia followed and persisted for 4 months. There was marked eiythroid hjrperplasia in the bone marrow, with striking dyserythropoiesis, PAS-positive erythrocyte precursors, moderate numbers of circulating normoblasts, and evidence of chronic and acute hemolysis. 

Cholestatic hepatitis occurred in a 61-year-old man with chronic myelocytic leukemia who had taken busulfan for 8 years (27). He presented with fever, abdominal pain, and raised liver enzymes. A liver biopsy showed cellular cholestasis with focal liver cell necrosis accompanied by a mild inflammatory infiltrate. When busulfan was withdrawn, his Uver enzymes normalized and his fever resolved. 

Ohnishi K, Ohno R, Tomonaga M et al (1995) A randomized trial comparing interferon-alfa with busulfan for newly diagnosed chronic myelogenous leukemia in chronic phase. Blood. 86 906-916... 

Presant and Bearman (1981) reported preliminary findings of a randomized trial that used isotretinoin either alone or in combination with busulfan for the treatment of patients with chronic phase chronic myelocytic leukemia. No differences have been noted in the time to development of blastic transformation in either group. The addition of the retinoid did not increase the acute toxicity of busulfan. Saccomanno et al. (1982) administered isotretinoin in 26 patients who exhibited varying degrees of cytologic atypia in exfoliated cells obtained from... 

Busulfan was used for the treatment of chronic myeloid leukemia and polycytemia vera. 

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... 

Busulfan (Myleran, Busulfex) [Antineoplastic/All lating Drug] Uses CML, preparative regimens for allogeneic ABMT in high... 

Hydroxyurea is used for the rapid lowering of blood granulocyte counts in patients with chronic granulocytic leukemia. The drug also can be used as maintenance therapy for patients with the disease who have become resistant to busulfan. Only a small percentage of patients with other malignancies have had even brief remissions induced by hydroxyurea administration. 

Using the optimal protocol combination of T/F/S and IL-3 that was developed from a series of preclinical studies (outlined above), autologous HSC gene therapy for ADA-SCID was performed in combination with nonmyeloablative conditioning (2 mg/kg/day of busulfan) in two patients (aged 7 months [Ptl], and two years and 6 months [Pt2], respectively) [515130], [515136], [607777]. 

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. 

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. 

Hydroxyurea suppresses DNA synthesis by inhibiting ribonucleoside diphosphate reductase, which catalyzes the reduction of ribonucleotides to deoxyribonucleotides. Hydroxyurea is used in chronic cases of granulocytic leukemia that are unresponsive to busulfan. In addition, it is used for acute lymphoblastic leukemia. Hydroxyurea may cause bone marrow depression. 

Bredschneider M, Klein K, Murdter TE, Marx C, Eichelbaum M, Nussler AK, Neuhaus P, Zanger UM, Schwab M. Genetic polymorphisms of glutathione S-transferase Al, the major glutathione S-transferase in human liver consequences for enzyme expression and busulfan conjugation. Clin Pharmacol Ther 2002 71 479 487. 

CALCIUM CHANNEL BLOCKERS BUSULFAN t plasma concentrations of busulfan and t risk of toxicity of busulfan such as veno-ocdusive disease and pulmonary fibrosis, when co-administered with diltiazem, nifedipine or verapamil Due to inhibition of CYP3A4-mediated metabolism of busulfan by these calcium channel blockers. Busulfan clearance may be l by 25%, and the AUC of busulfan may t by 1500 p,mol/L Monitor clinically for veno-ocdusive disease and pulmonary toxicity in transplant patients. Monitor busulfan blood levels as AUC of below 1500 p,mol/L per minute tends to prevent toxicity... 

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