USMLE

Busulfan

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Oncology Pharm
  1. Bleomycin
  2. Dactinomycin, Actinomycin D
  3. Doxorubicin, Daunorubicin
  4. Azathioprine, 6-MP
  5. Cladribine
  6. Cytarabine
  7. Busulfan
  8. Cyclophosphamide, Ifosfamide
  9. Nitrosoureas
  10. Paclitaxel
  11. Vincristine, Vinblastine
  12. Cisplatin, Carboplatin, Oxaliplatin
  13. Etoposide, Teniposide
  14. Irinotecan, Topotecan
  15. Bevacizumab
  16. Erlotinib
  17. Cetuximab, Panitumumab
  18. Imatinib, Dasatinib
  19. Rituximab
  20. Bortezomib, Carfilzomib
  21. Trastuzumab
  22. Dabrafenib, Vemurafenib
  23. Raloxifene and Tamoxifen
  24. Hydroxyurea
  25. Procarbazine

Summary

Busulfan is an alkylating agent that crosslinks DNA, affecting the ability of cells to multiply. This drug used to be the gold standard treatment for CML before imatinib was discovered. Nowadays, busulfan is clinically used for bone marrow ablation before bone marrow transplant. Related to this clinical use is the adverse effect of severe bone marrow suppression, also called myelosuppression. Patients taking busulfan may also experience pulmonary fibrosis.

Key Points

  • Busulfan
    • Mechanism
      • Alkylating agent that crosslinks DNA
    • Clinical Use
      • Bone marrow ablation before bone marrow transplantation 
      • CML
        • Was the gold standard treatment for CML before imatinib was discovered
    • Adverse Effects
      • Severe myelosuppression (nonspecific)
      • Pulmonary fibrosis
      • Hyperpigmentation