Monitoring of Busulphan Concentrations in Children Undergone Hematopoietic Stem Cell Transplantation: Unicentric Experience over 10 years

Abstract

We concluded that older age at HSCT, intravenous administration of busulphan, cumulative, and prescribed dose of busulphan are associated with higher AUC levels. The absence of significant correlations between toxic events, graft failure, and AUC suggests the efficacy of busulphan concentrations monitoring in our patients.

Busulfan systemic exposure and its relationship with efficacy and safety in hematopoietic stem cell transplantation in children: a meta-analysis

“…Nine [13-17, 23, 24, 26, 29] were prospective studies and four [2,20,25,27] were retrospective studies. Six studies were conducted in Europe [14,16,20,24,25,27], six studies were in United States [2,13,15,17,26,29] and one [23] was in Japan. Bu concentrations were measured by high-performance liquid chromatography by means of ultraviolet detection [23,29], while the remainder [2, 13-17, 20, 24-27] were measured by gas chromatography with mass spectrometry detection.…”

“…The quality assessment of the included studies is presented in Supplementary Table S5. Overall, the subjects included were representative, and ascertainment of exposure was confirmed by secure record, six studies were comparable on basis of main factors [2, 14-16, 24, 25], and seven studies were comparable on two or more factors [13,17,20,23,26,27,29]. Outcome assessment was based on pharmacy and medical records, the follow-up period was sufficient for outcomes to occur, and adequacy of follow-up of cohorts.…”

“…Outcome assessment was based on pharmacy and medical records, the follow-up period was sufficient for outcomes to occur, and adequacy of follow-up of cohorts. According to the NOS tool, the quality assessment showed that two studies [17,26] were scored 6 stars, four studies 7 stars [20,25,27,29], three studies [13,16,23] 8 stars, and four studies [2,14,15,24] 9 stars. No study was excluded after rating because the study quality was always above 5 stars.…”

“…Numerous observational studies have recommended target Bu exposure ranges at different cut-off values, including 900 [2,[12][13][14][15][16][17], 1000 [18], 1225 [11], 1350 [15][16][17], 1500 [14] and 1575 [11] μM × min for every 6-h dosage. On the contrary, some observational studies found no statistically significant differences in transplant-related toxicity (TRT) or graft failure rate between different Bu AUC [19][20][21].…”

Busulfan systemic exposure and its relationship with efficacy and safety in hematopoietic stem cell transplantation in children: A meta-analysis

“…Numerous observational studies have recommended target Bu exposure ranges at different cut-off values, including 900 [2,[12][13][14][15][16][17], 1000 [18], 1225 [11], 1350 [15][16][17], 1500 [14] and 1575 [11] µM × min for every 6-hour dosage. On the contrary, some observational studies found no statistically significant differences in transplant-related toxicity (TRT) or graft failure rate between different Bu AUC [19][20][21].…”