VERY LOW INCIDENCE OF NEUROTOXICITY WITHOUT ANTICONVULSANT PROPHYLAXIS DURING THE CONDITIONING REGIMEN WITH BUSULFAN IN PATIENTS UNDERGOING STEM CELL TRANSPLANTATION
(Abstract release date: 05/19/16)
EHA Library. Rivera Franco M. 06/09/16; 135077; PB2177
Dr. Monica Magdalena Rivera Franco
Contributions
Contributions
Abstract
Abstract: PB2177
Type: Publication Only
Background
Since neurotoxicities, including seizures, have been reported with the use of busulfan (BU), it is a trend to administer anticonvulsant prophylaxis during a conditioning regimen with this alkylating agent in patients undergoing hematopoietic stem cell transplantation (HSCT). On the other hand, anticonvulsant medications interact with busulfan metabolism, affecting its serum concentration and therapeutic activities, and have their own side effects on the patient which can alter the outcome of the transplant.
Aims
To analyze the frequency of neurotoxicity in patients who underwent stem cell transplantation with conditioning regimen including high doses of busulfan, without anticonvulsant prophylaxis, at INCMNSZ, from November 1998 to January 2016.
Methods
A retrospective analysis was performed in 97 patients receiving high-dose BU as part of their HSCT preparative regimen, at INCMNSZ, determining the frequency of seizures and other neurotoxicities.
Results
Ninety seven patients undergoing stem cell transplantation with conditioning regimen including busulfan, from November 1998 to January 2016, were included. Patients (male, 59%) had a median age of 33 years (range 15-61). The patients had a following range of underlying diseases: myelodysplastic syndrome (n=17, 17.5%), chronic myeloid leukemia (CML, n=13, 13.4%), acute lymphoblastic leukemia (LLA, n=19, 19.6%), acute myeloid leukemia (AML, n=31, 32%), or others (n=17, 17.5%). Patients who underwent an autologous transplant received high doses of busulfan, 16 mg/kg (n=24, 25%), and doses of 12mg/kg (n=73, 75%) were given for allogeneic transplant patients. None of the patients received anticonvulsant prophylaxis. Only one patient (1%), transplanted in 2011, presented seizures after the administration of BU, and was treated with phenytoin and benzodiazepines without further crisis.
Conclusion
From the beginning of our transplant program no anticonvulsant prophylaxis was given to patients receiving BU-based conditioning regimen for HSCT. Since neurotoxicities were not reported, we continued deferring the anticonvulsant prophylaxis. According to this data, we emphasize that in our experience, seizures are not frequent side effect of conditioning regimens including high dose busulfan, and therefore, anticonvulsant prophylactic regimens are not always necessary.
Session topic: E-poster
Keyword(s): Busulfan, Conditioning, Stem cell transplant, Toxicity
Type: Publication Only
Background
Since neurotoxicities, including seizures, have been reported with the use of busulfan (BU), it is a trend to administer anticonvulsant prophylaxis during a conditioning regimen with this alkylating agent in patients undergoing hematopoietic stem cell transplantation (HSCT). On the other hand, anticonvulsant medications interact with busulfan metabolism, affecting its serum concentration and therapeutic activities, and have their own side effects on the patient which can alter the outcome of the transplant.
Aims
To analyze the frequency of neurotoxicity in patients who underwent stem cell transplantation with conditioning regimen including high doses of busulfan, without anticonvulsant prophylaxis, at INCMNSZ, from November 1998 to January 2016.
Methods
A retrospective analysis was performed in 97 patients receiving high-dose BU as part of their HSCT preparative regimen, at INCMNSZ, determining the frequency of seizures and other neurotoxicities.
Results
Ninety seven patients undergoing stem cell transplantation with conditioning regimen including busulfan, from November 1998 to January 2016, were included. Patients (male, 59%) had a median age of 33 years (range 15-61). The patients had a following range of underlying diseases: myelodysplastic syndrome (n=17, 17.5%), chronic myeloid leukemia (CML, n=13, 13.4%), acute lymphoblastic leukemia (LLA, n=19, 19.6%), acute myeloid leukemia (AML, n=31, 32%), or others (n=17, 17.5%). Patients who underwent an autologous transplant received high doses of busulfan, 16 mg/kg (n=24, 25%), and doses of 12mg/kg (n=73, 75%) were given for allogeneic transplant patients. None of the patients received anticonvulsant prophylaxis. Only one patient (1%), transplanted in 2011, presented seizures after the administration of BU, and was treated with phenytoin and benzodiazepines without further crisis.
Conclusion
From the beginning of our transplant program no anticonvulsant prophylaxis was given to patients receiving BU-based conditioning regimen for HSCT. Since neurotoxicities were not reported, we continued deferring the anticonvulsant prophylaxis. According to this data, we emphasize that in our experience, seizures are not frequent side effect of conditioning regimens including high dose busulfan, and therefore, anticonvulsant prophylactic regimens are not always necessary.
Session topic: E-poster
Keyword(s): Busulfan, Conditioning, Stem cell transplant, Toxicity
Abstract: PB2177
Type: Publication Only
Background
Since neurotoxicities, including seizures, have been reported with the use of busulfan (BU), it is a trend to administer anticonvulsant prophylaxis during a conditioning regimen with this alkylating agent in patients undergoing hematopoietic stem cell transplantation (HSCT). On the other hand, anticonvulsant medications interact with busulfan metabolism, affecting its serum concentration and therapeutic activities, and have their own side effects on the patient which can alter the outcome of the transplant.
Aims
To analyze the frequency of neurotoxicity in patients who underwent stem cell transplantation with conditioning regimen including high doses of busulfan, without anticonvulsant prophylaxis, at INCMNSZ, from November 1998 to January 2016.
Methods
A retrospective analysis was performed in 97 patients receiving high-dose BU as part of their HSCT preparative regimen, at INCMNSZ, determining the frequency of seizures and other neurotoxicities.
Results
Ninety seven patients undergoing stem cell transplantation with conditioning regimen including busulfan, from November 1998 to January 2016, were included. Patients (male, 59%) had a median age of 33 years (range 15-61). The patients had a following range of underlying diseases: myelodysplastic syndrome (n=17, 17.5%), chronic myeloid leukemia (CML, n=13, 13.4%), acute lymphoblastic leukemia (LLA, n=19, 19.6%), acute myeloid leukemia (AML, n=31, 32%), or others (n=17, 17.5%). Patients who underwent an autologous transplant received high doses of busulfan, 16 mg/kg (n=24, 25%), and doses of 12mg/kg (n=73, 75%) were given for allogeneic transplant patients. None of the patients received anticonvulsant prophylaxis. Only one patient (1%), transplanted in 2011, presented seizures after the administration of BU, and was treated with phenytoin and benzodiazepines without further crisis.
Conclusion
From the beginning of our transplant program no anticonvulsant prophylaxis was given to patients receiving BU-based conditioning regimen for HSCT. Since neurotoxicities were not reported, we continued deferring the anticonvulsant prophylaxis. According to this data, we emphasize that in our experience, seizures are not frequent side effect of conditioning regimens including high dose busulfan, and therefore, anticonvulsant prophylactic regimens are not always necessary.
Session topic: E-poster
Keyword(s): Busulfan, Conditioning, Stem cell transplant, Toxicity
Type: Publication Only
Background
Since neurotoxicities, including seizures, have been reported with the use of busulfan (BU), it is a trend to administer anticonvulsant prophylaxis during a conditioning regimen with this alkylating agent in patients undergoing hematopoietic stem cell transplantation (HSCT). On the other hand, anticonvulsant medications interact with busulfan metabolism, affecting its serum concentration and therapeutic activities, and have their own side effects on the patient which can alter the outcome of the transplant.
Aims
To analyze the frequency of neurotoxicity in patients who underwent stem cell transplantation with conditioning regimen including high doses of busulfan, without anticonvulsant prophylaxis, at INCMNSZ, from November 1998 to January 2016.
Methods
A retrospective analysis was performed in 97 patients receiving high-dose BU as part of their HSCT preparative regimen, at INCMNSZ, determining the frequency of seizures and other neurotoxicities.
Results
Ninety seven patients undergoing stem cell transplantation with conditioning regimen including busulfan, from November 1998 to January 2016, were included. Patients (male, 59%) had a median age of 33 years (range 15-61). The patients had a following range of underlying diseases: myelodysplastic syndrome (n=17, 17.5%), chronic myeloid leukemia (CML, n=13, 13.4%), acute lymphoblastic leukemia (LLA, n=19, 19.6%), acute myeloid leukemia (AML, n=31, 32%), or others (n=17, 17.5%). Patients who underwent an autologous transplant received high doses of busulfan, 16 mg/kg (n=24, 25%), and doses of 12mg/kg (n=73, 75%) were given for allogeneic transplant patients. None of the patients received anticonvulsant prophylaxis. Only one patient (1%), transplanted in 2011, presented seizures after the administration of BU, and was treated with phenytoin and benzodiazepines without further crisis.
Conclusion
From the beginning of our transplant program no anticonvulsant prophylaxis was given to patients receiving BU-based conditioning regimen for HSCT. Since neurotoxicities were not reported, we continued deferring the anticonvulsant prophylaxis. According to this data, we emphasize that in our experience, seizures are not frequent side effect of conditioning regimens including high dose busulfan, and therefore, anticonvulsant prophylactic regimens are not always necessary.
Session topic: E-poster
Keyword(s): Busulfan, Conditioning, Stem cell transplant, Toxicity
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