title: Risk of seizures in children receiving busulphan-containing regimens for stem cell transplantation.
abstract: Busulphan (BU) is associated with neurotoxicity and risk of seizures. Hence, seizure prophylaxis is routinely utilized during BU administration for stem cell transplantation (SCT). We collected data on the incidence of seizures among children undergoing SCT in Italy. Fourteen pediatric transplantation centers agreed to report unselected data on children receiving BU as part of the conditioning regimen for SCT between 2005 and 2012. Data on 954 pediatric transplantation procedures were collected; of them, 66% of the patients received BU orally, and the remaining 34%, i.v. All the patients received prophylaxis of seizures, according to local protocols, consisting of different schedules and drugs. A total of 13 patients (1.3%) developed seizures; of them, 3 had a history of epilepsy (or other seizure-related pre-existing condition); 3 had documented brain lesions potentially causing seizures per se; 1 had febrile seizures, 1 severe hypo-osmolality. In the remaining 5 patients, seizures were considered not explained and, thus, potentially related to BU administration. The incidence of seizures in children receiving BU-containing regimen was very low (1.3%); furthermore, most of them had at least 1-either pre-existing or concurrent-associated risk factor for seizures.
authors.affiliation: Pediatric Hematology Oncology and Domiciliary Care, Azienda Ospedaliero-Universitaria A. Meyer Children Hospital, Firenze, Italy.
authors.forename: Désirée
authors.initials: D
authors.lastname: Caselli
authors.affiliation: Pediatric Hematology Oncology, Neurology, Azienda Ospedaliero-Universitaria A. Meyer Children Hospital, Firenze, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Rosati
authors.affiliation: Pediatric Hematology Oncology, Hematopoietic Stem Cell Transplant Unit, IRCCS G. Gaslini, Genova, Italy.
authors.forename: Maura
authors.initials: M
authors.lastname: Faraci
authors.affiliation: Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Podda
authors.affiliation: Pediatric Hematology-Oncology, A.O. Pausilipon, Napoli, Italy.
authors.forename: Mimmo
authors.initials: M
authors.lastname: Ripaldi
authors.affiliation: Pediatric Hematology-Oncology, University of Milano Bicocca, Ospedale San Gerardo, Monza, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Longoni
authors.affiliation: Pediatric Hematology-Oncology, Policlinico di Verona, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Cesaro
authors.affiliation: Pediatric Hematology-Oncology, Policlinico di Catania, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Lo Nigro
authors.affiliation: Pediatric Hematology Oncology and Domiciliary Care, Azienda Ospedaliero-Universitaria A. Meyer Children Hospital, Firenze, Italy.
authors.forename: Olivia
authors.initials: O
authors.lastname: Paolicchi
authors.affiliation: Pediatric Hematology-Oncology, IRCCS Burlo Garofolo, Trieste, Italy.
authors.forename: Natasha
authors.initials: N
authors.lastname: Maximova
authors.affiliation: Pediatric Hematology-Oncology, Azienda Ospedaliero-Universitaria Pisa, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Menconi
authors.affiliation: Pediatric Hematology-Oncology, ARNAS Ospedale Civico, Palermo, Italy.
authors.forename: Ottavio
authors.initials: O
authors.lastname: Ziino
authors.affiliation: Pediatric Hematology, Paediatric Immunology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute and San Raffaele Telethon Institute for Gene Therapy (HSR-TIGET), San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Cicalese
authors.affiliation: Pediatric Hematology-Oncology, Pescara, Italy.
authors.forename: Stella
authors.initials: S
authors.lastname: Santarone
authors.affiliation: Pediatric Hematology-Oncology, Ospedale Sant'Anna, Turin, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Nesi
authors.affiliation: Pediatric Hematology Oncology and Domiciliary Care, Azienda Ospedaliero-Universitaria A. Meyer Children Hospital, Firenze, Italy; Pediatric Oncology Regional Network, Istituto Toscano Tumori (I.T.T.), Firenze, Italy. Electronic address: maurizio.arico@ittumori.it.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Aricò
authors.affiliation: Pediatric Hematology-Oncology, IRCCS Bambino Gesù Children Hospital, Rome, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Locatelli
authors.affiliation: Pediatric Hematology-Oncology, University of Bologna, Bologna, Italy.
authors.forename: Arcangelo
authors.initials: A
authors.lastname: Prete
mesh_terms: D000293:Adolescent; D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects*; D002066:Busulfan / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007223:Infant; D008297:Male; D012640:Seizures / Q000139:chemically induced*; D055815:Young Adult
chemical_list: D018906:Antineoplastic Agents, Alkylating; D002066:Busulfan
keywords: Prophylaxis; Seizures