Busulfan is  a chemotherapy drug used before bone marrow transplantation procedures in chronic myelogenous leukemia patients . In its use, this drug is combined with other chemotherapy drugs, such as cyclophosphamide.

Busulfan works by inhibiting cell division so that the growth of cancer cells in the blood can be slowed down or stopped. Once all the cancer cells are gone, the patient will be ready to receive a bone marrow transplant which is expected to produce new healthy blood cells.

Busulfan trademark : Busulfex

What is Busulfan

Group Prescription drugs
Category Chemotherapy drugs
Benefits Conditioning the patient's blood before bone marrow transplantation in chronic myelogenous leukemia patients
Used by Adults and children
Busulfan for pregnant and lactating women

Category D : There is evidence that the content of the drug poses a risk to the human fetus, but the magnitude of the benefit may be greater than the risk, for example to overcome a life-threatening situation.

It is not yet known whether busulfan is absorbed into breast milk or not. However, all chemotherapy drugs are suspected to change the chemical structure of breast milk so they cannot be used in breastfeeding mothers.

Drug form Injectable liquid

Warnings Before Using Busulfan

There are several things that need to be considered before undergoing treatment with busulfan, namely:

  • Tell your doctor if you are allergic to busulfan or other chemotherapy drugs. Busulfan should not be used in patients who are allergic to this drug.
  • Tell your doctor if you are or have recently been infected with an infectious disease, especially a viral infection, such as chicken pox or herpes zoster.
  • Avoid contact with people who are suffering from infectious diseases, such as flu, chicken pox, or measles. The use of busulfan makes you susceptible to infectious diseases.
  • Tell the doctor if you have previously undergone chemotherapy, radiotherapy, or stem cell transplantation .
  • Tell your doctor if you have had or are currently suffering from epilepsy or seizures, head injury, respiratory disorders, high uric acid , kidney disease, or liver disease.
  • Tell your doctor if you have a blood disorder, such as thalassemia , anemia, porphyria , or thrombocytopenia .
  • Inform your doctor if you are pregnant, may be pregnant, planning to become pregnant, or are breastfeeding.
  • Use contraception while taking the drug, up to 6 months after the last dose for women or 3 months for men. Consult your doctor about the most effective contraceptive for you.
  • Do not undergo vaccination during treatment with busulfan.
  • Tell your doctor if you are using other drugs, including supplements and herbal products, to anticipate drug interactions.
  • See a doctor immediately if you experience a serious drug allergic reaction or side effect after using busulfan.

Dosage and Administration of Busulfan

The dose of busulfan will be determined by the doctor based on the condition and response of the patient's body to the drug. The following is the usual dose of busulfan given before bone marrow transplantation in chronic myelogenous leukemia (CML) patients:


0.8 mg/kgBW


  • Body weight <9 kg: 1 mg/kgBW
  • Body weight 9–15,9 kg: 1,2 mg/kgBW
  • Body weight 16–23 kg: 1.1 mg/kgBW
  • Body weight 23.1–34 kg: 0.95 mg/kgBW
  • Body weight >34 kg: 0.8 mg/kgBW

Busulfan was given for 4 days, starting 7 days before bone marrow transplantation. The dose is given through a central vein infusion every 6 hours, for 2 hours.

In preparation for bone marrow transplantation, the administration of busulfan is combined with another chemotherapy drug, namely cyclophosphamide. Cyclophosphamide was given for 2 days, starting 24 hours after busulfan was given.

How to Use Busulfan Correctly

Busulfan can only be given by a doctor or medical personnel under the supervision of a doctor. This drug is administered through a central vein infusion close to the heart. Usually, the infusion is installed in the neck area.

In addition to busulfan, you may also be given some other drugs to reduce the risk of side effects of busulfan. Immediately inform the doctor if you feel any disturbing side effects during the administration of busulfan.

You will also need to undergo several blood tests during therapy. This examination needs to be done so that the doctor can monitor the development of the condition, the effectiveness of the medicine, and the long-term side effects that may arise.

Interactions of Busulfan with Other Drugs

There are several drug interaction effects that can occur if busulfan is used with other drugs, including:

  • Infectious disease attacks if given together with live vaccines, such as BCG vaccine, influenza vaccine, measles vaccine , or typhoid vaccine
  • Increased rate and risk of side effects of busulfan if used together with itraconazole , metronidazole, or paracetamol
  • Decreased levels of busulfan in the blood if used with phenytoin
  • Increased risk of esophageal varices if used with thioguanine
  • Increased risk of fatal infectious diseases if used together with clozapine or immunosuppressant drugs , such as fingolimod or adalimumab
  • Increased risk of fatal blood clots if used with other chemotherapy drugs, such as thalidomide

Side Effects and Dangers of Busulfan

Some of the side effects that may arise due to the use of busulfan are:

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Loss of appetite
  • Thrush
  • Stomach ache or pain
  • Turn
  • Swelling in the feet, ankles, and hands
  • Warm feeling in the face, neck, or chest ( flushing )
  • Headache
  • Difficulty sleeping

If the condition does not improve or even worsens, report the side effects to the doctor. You also need to see a doctor immediately if you experience a serious drug allergic reaction or side effect, such as:

  • Pain, redness, or swelling at the infusion site
  • Liver disorders , which can be characterized by continuous nausea and vomiting, dark colored urine, abdominal pain, or jaundice
  • Mood changes, such as depression, hallucinations, restlessness and confusion
  • Muscle cramps
  • Frequent thirst or frequent urination
  • Fast or irregular heartbeat
  • Coughing blood
  • Pass bloody urine
  • Convulsions
  • Pass out
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