Therapeutic Drug Monitoring of Busulfan

[摘要] To the Editor:We were excited to read the clinical case study recently published in Clinical Chemistry (1), because the dosing of busulfan is a topic of great interest; however, one of the authors' Points to Remember was, “The therapeutic dose of intravenous busulfan is best predicted when the patient has achieved a Css” (1). We demonstrate that this statement is incorrect by addressing the question from both a theoretical and a practical point of view.Busulfan pharmacokinetics are described by a 1-compartment model. Thus, with intravenous administration, the pharmacokinetics are described by the parameter's clearance and volume of distribution. Because our aim is to achieve a constant area under the curve (AUC) for all patients, the clearance of busulfan is the most important parameter. The formula: Clearance=DoseAUC, demonstrates that if we know the clearance, we can adjust the dose to achieve a constant AUC. It does not matter if the patient is at steady state or not. Like other pharmacokinetic parameters, …

[学科分类] 过敏症与临床免疫学