title: Minimal incidence of neurotoxicity without prophylaxis during busulfan-based conditioning regimen in patients undergoing stem cell transplantation.
abstract: Busulfan (Bu), an alkylating agent, has been used in pre-transplant conditioning regimens since the 1950s, due to its potent myeloablative effect. Questions have been raised regarding oral or intravenous formulations, although both are known to be associated with serious side effects, including hepatic veno-occlusive disease, and neurotoxicity. The administration of anticonvulsant prophylaxis has become more common during high-dose Bu-based conditioning regimen; however, anticonvulsants can interfere with Bu pharmacokinetics and may have their own side effects, which can affect the outcome of the transplant. Our objective was to analyze the incidence of neurotoxicity in patients who underwent stem cell transplantation with high-dose Bu-based conditioning regimens without anticonvulsant prophylaxis. Ninety-seven patients were included, either having received a dose of 12 mg/kg (n = 73) for allogeneic transplantation or 16 mg/kg (n = 24) for autologous transplantation. The incidence of seizures was 0.01 %. We conclude that anticonvulsant prophylactic regimens may be unnecessary, and reduction of their use may help to avoid potential drug interactions and undesired side effects.
authors.affiliation: Stem Cell Transplantation Program, Hematology and Oncology Department, Instituto Nacional de Ciencias Medicas Y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Belisario Dominguez Seccion XVI, Tlalpan, 14080, Mexico City, Mexico. eucarios@hotmail.com.
authors.forename: Eucario
authors.initials: E
authors.lastname: Leon-Rodriguez
authors.affiliation: Stem Cell Transplantation Program, Hematology and Oncology Department, Instituto Nacional de Ciencias Medicas Y Nutricion Salvador Zubiran, Vasco de Quiroga 15, Belisario Dominguez Seccion XVI, Tlalpan, 14080, Mexico City, Mexico.
authors.forename: Monica M
authors.initials: MM
authors.lastname: Rivera-Franco
mesh_terms: D000293:Adolescent; D000328:Adult; D000477:Alkylating Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002066:Busulfan / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000008:administration & dosage / Q000009:adverse effects*; D012189:Retrospective Studies; D012640:Seizures / Q000139:chemically induced* / Q000209:etiology; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D019172:Transplantation Conditioning / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D000477:Alkylating Agents; D019653:Myeloablative Agonists; D002066:Busulfan
keywords: Busulfan; Seizures; Stem cell transplantation