Busulfan Disease Interactions

Busulfan can induce severe and prolonged myelosuppression. Treatment with busulfan should not be initiated in patients with known infectious diseases. All patients should be instructed to immediately report any signs or symptoms suggesting infection such as fever, sore throat, or local infection during therapy with busulfan. Close clinical monitoring of hematopoietic function is recommended.

Busulfan induces severe and prolonged myelosuppression at the recommended dosage. Hematopoietic progenitor cell transplantation is required to prevent potentially fatal complications of the prolonged myelosuppression. It is recommended to closely monitor complete blood counts, including white blood cell differentials, and quantitative platelet counts daily during treatment and until engraftment is demonstrated. Extreme caution should be exercised if busulfan is administered in patients whose bone marrow reserve may be compromised by prior irradiation or chemotherapy or whose marrow function is recovering from previous cytotoxic therapy. Patients should be instructed to immediately report any signs or symptoms suggesting bone marrow suppression, such as fever, sore throat, local infection, bleeding, or symptoms of anemia.

Cardiac tamponade during high dose busulfan therapy combined with cyclophosphamide has been reported in pediatric patients with thalassemia. Abdominal pain and vomiting may precede the tamponade. Cardiac tamponade can result in death and therapy with busulfan should be administered cautiously to patients with thalassemia.

Seizures have been reported in patients receiving high doses of busulfan. Therapy with busulfan should be administered cautiously to patients with a history of a seizure disorder or head trauma or who are receiving other potentially epileptogenic drugs.