title: Pretransplant conditioning in adults and children: dose assurance with intravenous busulfan.
abstract: OBJECTIVE
  To provide clinical insights into dosing and administration of IV busulfan, a conditioning agent for hematopoietic stem cell transplantation (HSCT).
  
  
  METHODS
  Review of published literature related to busulfan pretransplant conditioning using MEDLINE. Meeting abstracts, investigational protocols, and pharmaceutical manufacturers' package inserts also were reviewed.
  
  
  RESULTS
  Busulfan is an effective myeloablative conditioning agent for HSCT. The IV formulation increases dose assurance and the ability to target a therapeutic window. Therapeutic drug monitoring ensures that targeted blood levels are achieved, especially in children, thereby preventing underdosing, which can lead to disease progression or rejection, as well as overdosing, which can cause an increased risk of toxic side effects.
  
  
  CONCLUSIONS
  IV busulfan is a convenient, safe, and effective conditioning agent used in HSCT that has a predictable pharmacokinetic profile.
  
  
  CONCLUSIONS
  An understanding of the pharmacokinetic principles underlying the relationship between the therapeutic window for busulfan and optimal HSCT outcomes will facilitate proper dosing and administration of IV busulfan.
authors.affiliation: Pediatric Blood and Marrow Transplant Program, University Hospitals of Cleveland, USA. vicki.fisher@uhhs.com
authors.forename: Vicki L
authors.initials: VL
authors.lastname: Fisher
authors.forename: Yvonne J
authors.initials: YJ
authors.lastname: Barnes
authors.forename: Suzanne L
authors.initials: SL
authors.lastname: Nuss
mesh_terms: D000284:Administration, Oral; D000328:Adult; D002066:Busulfan / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics; D007223:Infant; D007262:Infusions, Intravenous; D012640:Seizures / Q000139:chemically induced / Q000517:prevention & control; D019172:Transplantation Conditioning / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D002066:Busulfan