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Optimizing Busulfan Pharmacokinetic Testing



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Busulfan Pharmacokinetics

Slide 3

June 2009

This is exactly the reason why we do pharmacokinetic testing for busulfan.  Both the success of stem cell engraftment and the risk of toxicity depend on the amount of busulfan that a given patient is exposed to.  Too much drug increases the likelihood of serious toxicity, but too little drug risks the entire transplant being unsuccessful.  So an accurate assessment of how much busulfan each patient is exposed to is essential.  To do this, we test a series of samples from patients receiving intravenous busulfan, and measure the serum drug concentration at each timepoint.  We’ll look at this in more detail in a moment, but the key point here is that this series of samples allows determination of overall exposure to busulfan, which is measured as the area under the concentration-time curve.  Other pharmacokinetic parameters are calculated from the AUC measurements, including busulfan clearance and an estimated dose. 

Although the analysis of several timepoints can increase both costs and the difficulty of obtaining samples, it’s been shown that busulfan pharmacokinetic testing is well worth the price.  Patients show improved engraftment and less-frequent toxicity when busulfan analysis is used to adjust dosing, at a cost of less than 1% of the total charges associated with stem cell transplantation.

Busulfan Pharmacokinetics

 


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