Busulfan levels are influenced by prior treatment and are associated with hepatic veno-occlusive disease and early mortality but not with delayed complications following marrow transplantation

Copelan, Edward A.; Bechtel, Thomas; Avalos, BR; Elder, Patrick; Ezzone, S A; Scholl, M D; Penza, Sam

doi:10.1038/sj.bmt.1703047

Cited by 69 publications

(62 citation statements)

References 15 publications

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“…Copelan et al 32 showed that preliminary prolonged exposure to conventional chemotherapy caused an increase in the plasma BU level, but no correlation with specific drugs was found in their study.…”

Section: Discussionmentioning

confidence: 98%

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Risk factors for hepatic veno-occlusive disease: a retrospective unicentric study in 116 children autografted after a high-dose BU-thiotepa regimen

Cacchione

Lemaître

Couanet

et al. 2008

Bone Marrow Transplant

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At our Institute, during the last decade, the incidence of hepatic veno-occlusive disease (HVOD) appears to be on the increase among pediatric patients treated with BUthiotepa (BU-TTP)-conditioning regimen. We thus performed a retrospective analysis to identify the risk factors for HVOD, which could explain such a change. In total, 116 patients treated at Institut Gustave Roussy, between May 1998 and December 2005 were eligible for this study having received BU-TTP as their first high-dose chemotherapy regimen, followed by autologous hematopoietic SCT (AHSCT). According to McDonald's clinical criteria, HVOD was diagnosed in 31% of these children. Demographic, clinical, biological and therapeutic parameters were evaluated in uni-and multivariate analyses that showed a significant correlation between previous carboplatin therapy and risk of developing post transplant HVOD (P ¼ 0.028). Comparable results were found for etoposide (P ¼ 0.048). In addition, a correlation between HVOD and risk of post transplant death was linked to its association with other types of organ failure (P ¼ 0.029). This study demonstrates that previous VPCARBO administration in conventional chemotherapy significantly increases the risk of HVOD among brain tumor patients later consolidated with BU-TTP followed by AHSCT.

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Section: Discussionmentioning

confidence: 98%

“…Other series have also shown that pulmonary and renal dysfunction were often associated with HVOD. 32,34 …”

Section: Discussionmentioning

confidence: 99%

Risk factors for hepatic veno-occlusive disease: a retrospective unicentric study in 116 children autografted after a high-dose BU-thiotepa regimen

Cacchione

Lemaître

Couanet

et al. 2008

Bone Marrow Transplant

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“…Furthermore, since the pharmacokinetic profile of orally administered Bu demonstrates wide interpatient and intrapatient variability due to age-related differences, alterations in absorption, circadian variations and drugdrug interactions, the oral administration of high-dose Bu for SCT can cause a significant risk of hepatic toxicity. [23][24][25] Although attempts to develop an i.v. preparation of Bu were initially limited due to the drug's poor aqueous solubility, several formulations have since been investigated, including a formulation that uses dimethyl acetamide and polyethylene glycol (i.v.…”

Section: Discussionmentioning

confidence: 99%

Multicenter study of intravenous busulfan, cyclophosphamide, and etoposide (i.v. Bu/Cy/E) as conditioning regimen for autologous stem cell transplantation in patients with non-Hodgkin's lymphoma

Chae

et al. 2007

Bone Marrow Transplant

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The current study aimed to evaluate the efficacy and toxicity of a combination of intravenous busulfan, cyclophosphamide and etoposide (i.v. Bu/Cy/E) as a conditioning regimen prior to autologous hematopoietic stem cell transplantation in patients with non-Hodgkin's lymphoma (NHL). Sixty-four patients with relapsed/ refractory (n ¼ 36) or high-risk (n ¼ 28) lymphoma were enrolled. The high-dose chemotherapy consisted of i.v. Bu (0.8 mg kg À1 i.v. q 6 h from day À7 to day À5), Cy (50 mg kg À1 i.v. on day À3 and day À2) and E (400 mg m À2 i.v. on day À5 and day À4). The median age was 43 (range 18-65) years, and 39 patients were male. Diffuse large B-cell lymphoma (40.6%) was the most common histological subtype. All evaluable patients achieved an engraftment of neutrophils (median, day 12) and platelets (median, day 13). Hepatic veno-occlusive disease was observed in four patients (three mild, one moderate grade), and two patients (3.1%) died from treatment-related complications. At a median follow-up of 16.4 months, 15 patients (23.4%) exhibited a relapse or progression, while 13 patients (20.3%) had died of disease. The estimated 3-year overall and progression-free survival for all patients was 72.1 and 70.1%, respectively. In conclusion, the conditioning regimen of i.v. Bu/Cy/E was well tolerated and seemed to be effective in patients with aggressive NHL.

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“…1 To overcome the disadvantage of oral BU including gastrointestinal absorption, [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] i.v. BU was recently introduced into clinical use.…”

Section: Introductionmentioning

confidence: 99%

Busulfex (i.v. BU) and CY regimen before SCT: Japanese-targeted phase II pharmacokinetics combined study

Kim¹,

Mori²,

Tanosaki³

et al. 2008

Bone Marrow Transplant

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Busulfan levels are influenced by prior treatment and are associated with hepatic veno-occlusive disease and early mortality but not with delayed complications following marrow transplantation

Cited by 69 publications

References 15 publications

Risk factors for hepatic veno-occlusive disease: a retrospective unicentric study in 116 children autografted after a high-dose BU-thiotepa regimen

Risk factors for hepatic veno-occlusive disease: a retrospective unicentric study in 116 children autografted after a high-dose BU-thiotepa regimen

Multicenter study of intravenous busulfan, cyclophosphamide, and etoposide (i.v. Bu/Cy/E) as conditioning regimen for autologous stem cell transplantation in patients with non-Hodgkin's lymphoma

Busulfex (i.v. BU) and CY regimen before SCT: Japanese-targeted phase II pharmacokinetics combined study

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