IV Busulfan Dose Individualization in Children undergoing Hematopoietic Stem Cell Transplant: Limited Sampling Strategies
2008; Elsevier BV; Volume: 14; Issue: 5 Linguagem: Inglês
10.1016/j.bbmt.2008.03.002
ISSN1523-6536
AutoresL. Lee Dupuis, Cathryn Sibbald, Tal Schechter, Marc Ansari, Adam Gassas, Yves Théorêt, Nastya Kassir, Martin Champagne, John Doyle,
Tópico(s)Childhood Cancer Survivors' Quality of Life
ResumoWe currently calculate area under the busulfan concentration time curve (AUC) using 7 plasma busulfan concentrations (AUC7) drawn after the first of 16 i.v. busulfan doses given as a 2-hour infusion every 6 hours. The aim of this study was to develop and validate limited sampling strategies (LSSs) using 3 or fewer busulfan concentration values with which to reliably calculate AUC in children undergoing hematopoietic stem cell transplant (HSCT). Children in the development group (44) received i.v. busulfan at Sick Kids; the validation group consisted of 35 children who received care at CHU Ste-Justine. Busulfan doses given and subsequent plasma busulfan concentrations were recorded. LSSs using 1 to 3 concentration-time points were developed using multiple linear regression. LSS were considered to be acceptable when adjusted r(2) > 0.9, mean bias <15% and precision 1500 or <900 microM x min were noted. LSSs using 1, 2, or 3 plasma busulfan concentrations were developed that showed excellent agreement with AUC7 and adjusted busulfan doses. In the validation sample, only the 2- and 3-point LSSs demonstrated acceptable precision and lack of bias. LSSs using 2 or 3 plasma busulfan concentrations can be used to reliably estimate busulfan AUC after IV administration in children undergoing HSCT.
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