Busulfan followed by cyclophosphamide (BuCy2) is indicated as conditioning treatment prior to conventional haematopoietic progenitor cell transplantation (HPCT) in adult patients when the combination is considered the best available option.
Busulfan following fludarabine (FB) is indicated as conditioning treatment prior to haematopoietic progenitor cell transplantation (HPCT) in adult patients who are candidates for a reduced-intensity conditioning (RIC) regimen.
Busulfan followed by cyclophosphamide (BuCy4) or melphalan (BuMel) is indicated as conditioning treatment prior to conventional haematopoietic progenitor cell transplantation in paediatric patients.
For this indication, competent medicine agencies globally authorize below treatments:
Intravenous
3.2 - 4.8 mg per kg of body weight
From 0.8 To 1.2 mg per kg of body weight 4 time(s) per day every day for 4 day(s)
The recommended dose of busulfan is as follows:
| Actual body weight (kg) | Busulfan dose (mg/kg) |
|---|---|
| <9 | 1.0 |
| 9 to <16 | 1.2 |
| 16 to 23 | 1.1 |
| >23 to 34 | 0.95 |
| >34 | 0.8 |
followed by:
Busulfan is administered as a two-hour infusion every 6 hours over 4 consecutive days for a total of 16 doses prior to cyclophosphamide or melphalan and haematopoietic progenitor cell transplantation (HPCT).
Busulfan should be administered by intravenous infusion via central venous catheter. Busulfan should not be given by rapid intravenous, bolus or peripheral injection.
Oral
120 - 150 mg per m² of body surface area (BSA)
From 30 To 37.5 mg per m² of body surface area (BSA) 4 time(s) per day every day for 4 day(s)
The conventional dosage plan for conditioning before haemopoietic stem cell transplantation is 30 to 37.5 mg/m² every 6 hours for 4 days, starting seven days prior to transplantation. 60 mg/kg per day of cyclophosphamide is usually given for two days commencing 24 h after the final dose of Busulfan.