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Review
. 2024 Dec;59(12):1641-1653.
doi: 10.1038/s41409-024-02413-0. Epub 2024 Sep 13.

A practical guide to therapeutic drug monitoring in busulfan: recommendations from the Pharmacist Committee of the European Society for Blood and Marrow Transplantation (EBMT)

Vera Domingos  1 , Katerina Nezvalova-Henriksen  2 , Adrin Dadkhah  3   4 , Maria-Estela Moreno-Martinez  5   6 , Khalil Ben Hassine  7   8 , Vera Pires  1 , Nicolaus Kröger  3 , Tiene Bauters  9 , Moustapha Hassan  10   11 , Nick Duncan  12 , Krzysztof Kalwak  13 , Marc Ansari #  7   8 , Claudia Langebrake #  3   4 , Rick Admiraal #  14
Affiliations
Review

A practical guide to therapeutic drug monitoring in busulfan: recommendations from the Pharmacist Committee of the European Society for Blood and Marrow Transplantation (EBMT)

Vera Domingos et al. Bone Marrow Transplant. 2024 Dec.

Abstract

Busulfan (Bu) is an important component of many conditioning regimens for allogeneic hematopoietic cell transplantation. The therapeutic window of Bu is well characterized, with strong associations between Bu exposure and the clinical outcome in adults (strongest evidence in myelo-ablative setting) and children (all settings). We provide an overview of the literature on Bu as well as a step-by-step guide to the implementation of Bu therapeutic drug monitoring (TDM). The guide covers the clinical, pharmacological, laboratory and administrative aspects of the procedure. Through this document, we aim to support centers in implementing TDM for Bu to further enhance the success rates of HCT and improve patient outcomes. The Pharmacist Committee of the European Society for Blood and Marrow Transplantation (EBMT) encourages all centers to perform TDM for Bu in the aforementioned indications.

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Conflict of interest statement

Competing interests: MEMM declares honoraria as a speaker, consultancy or advisory role from Daiichy Sankio España, GSK, Gilead, Incyte, Seagen, Servier, all not related to the current topic. ND declares honoraria as a speaker from Novartis and Gilead, and travel grants from Novartis. KK declares honoraria as a speaker from Medac, Novartis, Pierre Fabre and travel grants from Pierre-Fabre, all not related to the current topic. RA declares an unrestricted research grant from Sanofi, not related to the current topic. VD, KNH, AD, KBH, VP, NK, TB, MH, MA and CL declare no conflicts of interest.

References

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