Names and pronunciation
(byoo-sul′fan) Busulfex, Myleran
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Drug reference
(byoo-sul′fan) Busulfex, Myleran
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Func. class.: Antineoplastic alkylating agent
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USES: Chronic myelocytic leukemia, bone marrow ablation, stem cell trans- plant preparation with CML
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CONTRAINDICATIONS: Preg- nancy, breastfeeding, blastic phase of chronic myelocytic leukemia, hypersen- sitivity Precautions: Women of childbearing age, leukopenia, anemia, hepatotoxicity, renal toxicity, seizures, tumor lysis syndrome, hyperkalemia, hyperphosphatemia, hypo- calcemia, hyperuricemia, radiation, che- motherapy, male-mediated teratogenicity, veno-occlusive disease (VOD), sinusoidal obstruction syndrome, head trauma
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Black Box Warning: Thrombocytopenia, neutropenia, new primary malignancy, bone marrow suppression
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DOSAGE AND ROUTES Chronic myelocytic leukemia • Adult: PO Induction dosing is 60 mcg/kg or 1.8 mg/m2 every day; usual dose is 4 to 8 mg • Child: PO 0.06-0.12 mg/kg/day or 1.8- 4.6 mg/m2/day Allogenic hematopoietic stem cell transplantation • Adult: IV 0.8 mg/kg over 2 hr, q6hr × 4 days (total 16 doses); give cyclophos- phamide IV 60 mg/kg over 1 hr daily for 2 days starting after 16th dose of busul- fan; PO (unlabeled) 1 mg/kg q6hr × 16 doses • Adolescent and child >12 kg (unla- beled): IV 0.8 mg/kg over 2 hr q6hr × 16 doses (4 days), then high-dose cy- clophosphamide 50 mg/kg/day × 4 days • Infant/child #12 kg (unlabeled): IV 1.1 mg/kg over 2 hr q6hr × 16 doses (4 days), then high-dose cyclophosphamide 50 mg/kg/day × 4 days
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Available forms: Injection 6 mg/mL, tablets 2 mg See Appendix B HIGH ALERT
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• Adolescent and child >12 kg (unla- beled): IV 0.8 mg/kg over 2 hr q6hr × 16 doses (4 days), then high-dose cy- clophosphamide 50 mg/kg/day × 4 days
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