Busulfan

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Image:Busulfan.svg
Image:Busulfan3d.png
Busulfan
Systematic (IUPAC) name
1,4-bis(methylsulfonyloxy)butane
Identifiers
CAS number	55-98-1
ATC code	L01AB01
PubChem	2478
DrugBank	APRD00664
Chemical data
Formula	C6H14O6S2
Mol. mass	246.304 g/mol
Pharmacokinetic data
Bioavailability	80% (oral)
Protein binding	32.4%
Metabolism	Hepatic
Half life	2.5 hours
Excretion	?
Therapeutic considerations
Licence data	EU, US
Pregnancy cat.	D(US)
Legal status	℞ Prescription only
Routes	Oral, parenteral

WikiDoc Resources for Busulfan
Articles
Most recent articles on Busulfan Most cited articles on Busulfan Review articles on Busulfan Articles on Busulfan in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Busulfan Images of Busulfan Photos of Busulfan Podcasts & MP3s on Busulfan Videos on Busulfan
Evidence Based Medicine
Cochrane Collaboration on Busulfan Bandolier on Busulfan TRIP on Busulfan
Clinical Trials
Ongoing Trials on Busulfan at Clinical Trials.gov Trial results on Busulfan Clinical Trials on Busulfan at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Busulfan NICE Guidance on Busulfan NHS PRODIGY Guidance FDA on Busulfan CDC on Busulfan
Books
Books on Busulfan
News
Busulfan in the news Be alerted to news on Busulfan News trends on Busulfan
Commentary
Blogs on Busulfan
Definitions
Definitions of Busulfan
Patient Resources / Community
Patient resources on Busulfan Discussion groups on Busulfan Patient Handouts on Busulfan Directions to Hospitals Treating Busulfan Risk calculators and risk factors for Busulfan
Healthcare Provider Resources
Symptoms of Busulfan Causes & Risk Factors for Busulfan Diagnostic studies for Busulfan Treatment of Busulfan
Continuing Medical Education (CME)
CME Programs on Busulfan
International
Busulfan en Espanol Busulfan en Francais
Businness
Busulfan in the Marketplace Patents on Busulfan
Experimental / Informatics
List of terms related to Busulfan

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Overview

Busulfan is a chemotherapy drug that is a cell cycle non-specific alkylating agent (slows the growth of cancer cells). More specifically it belongs to a subclass of alkylating agents known as alkyl sulfonates. It is marketed in the U.S. by GlaxoSmithKline under the brand name Myleran, and has been in clinical use since 1959. Busulfan is also available in an IV formulation marketed as Busulfex by PDL BioPharma, Inc. Its chemical designation is 1,4-Butanediol dimethanesulfonate.

Uses

Currently, its main uses are in bone marrow transplantation, especially in chronic myelogenous leukemia (CML), where it is used as a conditioning drug. Busulfan can control tumor burden but cannot prevent transformation or correct cytogenic abnormalities. Though not as common, it may also be used for Chronic Lymphocytic Leukemia (CLL).

Its mechanism of action through alkylation produces DNA-DNA and DNA-protein cross linking. The resulting covalent bonds inhibit DNA, RNA, and protein synthesis. The inhibition of DNA synthesis subsequently produces a cytotoxic effect.

The drug was recently used in a study to examine the role of platelet-transported serotonin in liver regeneration.^[1]

Toxicity and side effects

Toxicity may include interstitial pulmonary fibrosis, hyperpigmentation, seizures, hepatic (veno-occlusive disease) and wasting syndrome. Phenytoin may be used concurrently to prevent the seizures.

1,4-Butanediol dimethanesulfonate is listed by the IARC as a Group 1 carcinogen.

Busulfan also induces thrombocytopenia, a condition of lowered blood platelet count and activity.

Historical

Busulfan use to be the standard of treatment for Chronic Myeloid Leukemia (CML) until it was replaced with the new gold standard, Imatinib.

References

External links

• Myleran (PDF prescribing information)
• Busulfex (PDF prescribing information)
• Detailed information

v • d • e Chemotherapeutic agents/Antineoplastic agents (L01)
Alkylating and alkylating-like agents	Nitrogen mustards: (Chlorambucil, Chlormethine, Cyclophosphamide, Ifosfamide, Melphalan, Bendamustine, Uramustine) Nitrosoureas:(Carmustine, Fotemustine, Lomustine, Streptozocin) Platinum (alkylating-like): (Carboplatin, Cisplatin, Oxaliplatin, Triplatin tetranitrate, Satraplatin) Alkyl sulfonates:(Busulfan, Treosulfan) Hydrazines:(Procarbazine, Dacarbazine, Temozolomide) Aziridines:(ThioTEPA)
Antimetabolites	Folic acid: (Aminopterin, Methotrexate, Pemetrexed, Raltitrexed). Purine:(Cladribine, Clofarabine, Fludarabine, Mercaptopurine, Pentostatin, Thioguanine) Pyrimidine:(Capecitabine, Cytarabine, Decitabine, Fluorouracil, Floxuridine, Gemcitabine)
Spindle poison/mitotic inhibitor	Taxane: (Docetaxel, Larotaxel, Paclitaxel). Vinca: (Vinblastine, Vincristine, Vindesine, Vinorelbine).
Cytotoxic/antitumor antibiotics	Anthracycline family: (Daunorubicin, Doxorubicin, Epirubicin, Idarubicin, Mitoxantrone, Pixantrone, Valrubicin) streptomyces (Actinomycin, Bleomycin, Mitomycin, Plicamycin) - Hydroxyurea
Topoisomerase inhibitors	Camptotheca: (Camptothecin, Topotecan, Irinotecan, Rubitecan), Podophyllum:(Etoposide, Teniposide)
CI monoclonal antibodies	Receptor tyrosine kinase (Cetuximab, Panitumumab, Trastuzumab) - CD20 (Rituximab, Tositumomab) - other (Alemtuzumab, Bevacizumab, Gemtuzumab)
Photosensitizers	Aminolevulinic acid, Methyl aminolevulinate, Porfimer sodium, Verteporfin
Tyrosine kinase inhibitors	Axitinib, Bosutinib, Cediranib, Dasatinib, Erlotinib, Gefitinib, Imatinib, Lapatinib, Lestaurtinib, Nilotinib, Semaxanib, Sorafenib, Sunitinib, Vandetanib
Cyclin-dependent kinase inhibitor	Seliciclib
Other	retinoids (Alitretinoin, Tretinoin), Fusion protein (Aflibercept) - Altretamine, Amsacrine, Anagrelide, Arsenic trioxide, Asparaginase (Pegaspargase), Bexarotene, Bortezomib, Celecoxib, Denileukin diftitox, Elesclomol, Estramustine, Irofulven, Ixabepilone, Masoprocol, Mitotane, Oblimersen, Testolactone, Tipifarnib, Trabectedin

v • d • e WikiDoc Research Resources for Busulfan
Articles on Busulfan	Most recent articles on Busulfan • Most cited articles on Busulfan • Review articles on Busulfan • Articles on Busulfan in N Eng J Med, Lancet, BMJ
Media (Slides, Video, Images, MP3) on Busulfan	Powerpoint slides on Busulfan • Images of Busulfan • Photos of Busulfan • Podcasts & MP3s on Busulfan • Videos on Busulfan
Evidence Based Medicine Regarding Busulfan	Cochrane Collaboration on Busulfan • Bandolier on Busulfan • TRIP on Busulfan
Cost Effectiveness of Busulfan	Cost Effectiveness of Busulfan
Clinical Trials Involving Busulfan	Ongoing Trials on Busulfan at Clinical Trials.gov • Trial results on Busulfan • Clinical Trials on Busulfan at Google
Guidelines / Policies / Government Resources (FDA/CDC) Regarding Busulfan	US National Guidelines Clearinghouse on Busulfan • NICE Guidance on Busulfan • NHS PRODIGY Guidance • FDA on Busulfan • CDC on Busulfan
Textbook Information on Busulfan	Books and Textbook Information on Busulfan
Pharmacology Resources on Busulfan	Dosing of Busulfan • Drug interactions with Busulfan • Side effects of Busulfan • Allergic reactions to Busulfan • Overdose information on Busulfan • Carcinogenicity information on Busulfan • Busulfan in pregnancy • Pharmacokinetics of Busulfan •
Genetics, Pharmacogenomics, and Proteinomics of Busulfan	Genetics of Busulfan • Pharmacogenomics of Busulfan • Proteomics of Busulfan
Newstories on Busulfan	Busulfan in the news • Be alerted to news on Busulfan • News trends on Busulfan
Commentary on Busulfan	Blogs on Busulfan
Patient Resources on Busulfan	Patient resources on Busulfan • Discussion groups on Busulfan • Patient Handouts on Busulfan • Directions to Hospitals Treating Busulfan • Risk calculators and risk factors for Busulfan
Healthcare Provider Resources on Busulfan	Symptoms of Busulfan • Causes & Risk Factors for Busulfan • Diagnostic studies for Busulfan • Treatment of Busulfan
Continuing Medical Education (CME) Programs on Busulfan	CME Programs on Busulfan
International Resources on Busulfan	Busulfan en Espanol • Busulfan en Francais
Business Resources on Busulfan	Busulfan in the Marketplace • Patents on Busulfan
Informatics Resources on Busulfan	List of terms related to Busulfan

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Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .