Individual dose adjustment of oral busulfan using a test dose in hematopoietic stem cell transplantation.

Individual dose adjustment of oral busulfan using a test dose in hematopoietic stem cell transplantation. Research Abstract Details 

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Individual dose adjustment of oral busulfan using a test dose in hematopoietic stem cell transplantation. Abstract Text:

Yasushi Takamatsu,Noriaki Sasaki,Tetsuya Eto,Koji Nagafuji,Yasunobu Abe,Ilseung Choi,Kentaro Ogata,Shuuji Hara,Junji Suzumiya,Kazuo Tamura,Yasushi Takamatsu,Noriaki Sasaki,Tetsuya Eto,Koji Nagafuji,Yasunobu Abe,Ilseung Choi,Kentaro Ogata,Shuuji Hara,Junji Suzumiya,Kazuo Tamura,

Maintaining the appropriate average steady-state plasma concentrations (Css) of busulfan (BU) is critical for both successful engraftment and minimizing toxicity in hematopoietic stem cell transplantation (HST). We therefore performed a prospective trial with 50 adult Japanese patients that involved adjusting the BU dose in accordance with individual BU pharmacokinetics (PK). After administering a 0.5-mg/kg test dose of oral BU, we analyzed individual BU PK parameters and calculated an adjusted BU dose that would achieve a target BU Css of 850 ng/mL. Thirty-nine patients (78%) required a BU dose decrease, and the median adjusted BU dose was 0.81 mg/kg (range, 0.51-1.29 mg/kg). All patients who underwent allogeneic HST received the adjusted BU dose. After administering the sixth BU dose, we measured the plasma BU concentration. The actual BU concentration was significantly correlated with the expected BU concentration, and the predictability of the BU Css was 103% +/- 9%. The incidence of toxicity excluding oral mucositis was low, and there was no regimen-related toxicity-associated mortality. Engraftment was achieved in 98% of the patients. This study showed that our method for adjusting the BU dose facilitated reliable prediction of the actual BU Css and that individualized BU dose adjustment was able to improve clinical outcomes in HST recipients treated with a BU-containing conditioning regimen.

Individual dose adjustment of oral busulfan using a test dose in hematopoietic stem cell transplantation. Publishing Authors By Initials

Y Takamatsu,N Sasaki,T Eto,K Nagafuji,Y Abe,I Choi,K Ogata,S Hara,J Suzumiya,K Tamura,Y Takamatsu,N Sasaki,T Eto,K Nagafuji,Y Abe,I Choi,K Ogata,S Hara,J Suzumiya,K Tamura,

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Individual dose adjustment of oral busulfan using a test dose in hematopoietic stem cell transplantation. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: International journal of hematology

VOLUME: 86

Page Numbers: 261-8

Journal Abbreviation: Int. J. Hematol.

ISSN: 0925-5710

DAY: 8

MONTH: Oct

YEAR: 2007

Individual dose adjustment of oral busulfan using a test dose in hematopoietic stem cell transplantation. Information

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LANGUAGE: eng

NlmUniqueID: 9111627

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AFFILIATION: First Department of Internal Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan. yasushi@fukuoka-u.ac.jp

Country: United States

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MEDLINETA: Int J Hematol

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