title: Once-daily intravenous busulfan for 47 pediatric patients undergoing autologous hematopoietic stem cell transplantation: a single center study.
abstract: We report our results using once-daily intravenous (IV) busulfan (Bu)-based conditioning adjusted by weight without drug monitoring as myeloablative conditioning in 47 pediatric patients undergoing first autologous hematopoietic transplantation from 2006 to 2010. Median age was 4 years (range, 1 to 22 y). There were 35 boys and 12 girls. Conditioning was Bu-based in all patients. In medulloblastoma patients (n=12), IV thiotepa at 5 mg/kg/d×2 days was associated with Bu. In solid tumors other than medulloblastoma, IV melphalan was used at 140 mg/m/d×1 day. In lymphoma patients (n=9), IV cyclophosphamide was used at 60 mg/kg/d×2 days. Median number of CD34 cells infused was 4.65×10/kg (range, 1.7 to 58.7×10/kg). Median times to neutrophil and platelet recovery (>20×10/L) were 11 days (range, 8 to 16 d) and 12 days (range, 7 to 135 d), respectively. Median hospitalization time was 14 days (range, 9 to 92 d). Sixteen patients developed grades III and IV mucositis. Only 1 patient developed mild sinusoidal obstruction syndrome. No patient developed seizures or severe neurological complications. With a median follow-up of 18 months, probability of transplantation-related mortality and disease-free survival were 0% and 70%±8%, respectively. In conclusion, in our experience, once-daily IV Bu-based conditioning without drug monitoring for autologous hematopoietic transplantation in pediatric patients is a safe and effective regimen with no mortality.
authors.affiliation: Stem Cell Transplant Unit, Hospital Niño Jesus, Madrid, Spain. mgonzalezv.hnjs@salud.madrid.org
authors.forename: Marta
authors.initials: M
authors.lastname: González-Vicent
authors.forename: Blanca
authors.initials: B
authors.lastname: Molina
authors.forename: Antonio
authors.initials: A
authors.lastname: Pérez
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Díaz
mesh_terms: D000293:Adolescent; D000328:Adult; D002066:Busulfan / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D019650:Hematopoietic Stem Cell Mobilization; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous; D008297:Male; D019653:Myeloablative Agonists / Q000008:administration & dosage*; D009369:Neoplasms / Q000401:mortality* / Q000628:therapy*; D011379:Prognosis; D015996:Survival Rate; D019172:Transplantation Conditioning; D055815:Young Adult
chemical_list: D019653:Myeloablative Agonists; D002066:Busulfan