TY - JOUR
T1 - Once-daily intravenous busulfan with therapeutic drug monitoring compared to conventional oral busulfan improves survival and engraftment in children undergoing allogeneic stem cell transplantation
AU - Bartelink, I.H.
AU - Bredius, R.G.
AU - Ververs, F.F.T.
AU - Raphael, M.F.
AU - van Kesteren, Charlotte
AU - Bierings, M.B.
AU - Rademaker, C.M.A.
AU - den Hartigh, J.
AU - Uiterwaal, C.S.P.M.
AU - Zwaveling, J.
AU - Boelens, J.J.
PY - 2008/1
Y1 - 2008/1
N2 - Because of intra- and interindividual variability, bioavailability, and pharmacokinetics of busulfan (Bu) in children, oral busulfan without therapeutic drug monitoring (TDM) is assumed to be associated with higher graft failure rates as well as higher toxicity (eg, veno-occlusive disease [VOD]). This study compares the outcome of hematopoietic stem cell transplantation (HSCT) of 2 groups: 1) 30 patients who received myeloablation with once-daily intravenous (i.v.) dose-targeted busulfan (BUdtIV) based on TDM and 2) 30 patients who received the current practice of untargeted oral busulfan (BLTPO). Patients received a 3-hour infusion of Bu at a first dose of 120 mg/m(2) (age >= 1 year) or 80 mg/m(2) (<1 year), or BUPO 1 mg/kg 4 times daily. Both regimens were continued for 4 days. The target area under the curve (AUC) was defined as 17,500 mu g*h/1. BUdtIV resulted in higher event-free survival (EFS) and survival rates compared to BUPO (EFS: 30% versus 83 %, P
AB - Because of intra- and interindividual variability, bioavailability, and pharmacokinetics of busulfan (Bu) in children, oral busulfan without therapeutic drug monitoring (TDM) is assumed to be associated with higher graft failure rates as well as higher toxicity (eg, veno-occlusive disease [VOD]). This study compares the outcome of hematopoietic stem cell transplantation (HSCT) of 2 groups: 1) 30 patients who received myeloablation with once-daily intravenous (i.v.) dose-targeted busulfan (BUdtIV) based on TDM and 2) 30 patients who received the current practice of untargeted oral busulfan (BLTPO). Patients received a 3-hour infusion of Bu at a first dose of 120 mg/m(2) (age >= 1 year) or 80 mg/m(2) (<1 year), or BUPO 1 mg/kg 4 times daily. Both regimens were continued for 4 days. The target area under the curve (AUC) was defined as 17,500 mu g*h/1. BUdtIV resulted in higher event-free survival (EFS) and survival rates compared to BUPO (EFS: 30% versus 83 %, P
KW - busulfan
KW - allogeneic stem cell transplantation
KW - therapeutic drug monitoring
KW - BONE-MARROW-TRANSPLANTATION
KW - ADVANCED HEMATOLOGIC MALIGNANCIES
KW - VENO-OCCLUSIVE DISEASE
KW - HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS
KW - VENOOCCLUSIVE DISEASE
KW - CONDITIONING THERAPY
KW - DOSE ADJUSTMENT
KW - PEDIATRIC-PATIENTS
KW - COMPLETE REMISSION
KW - MYELOID-LEUKEMIA
U2 - 10.1016/j.bbmt.2007.09.015
DO - 10.1016/j.bbmt.2007.09.015
M3 - Article
SN - 1083-8791
VL - 14
SP - 88
EP - 98
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 1
ER -