Busulfan vs Allele

[EPguy]

I stumbled on some studies of the old Chemo drug busulfan. It seems it can affect allele burden, as well as hem responses. I had no idea about this. They also suggest it's not especially leukemogenic in the 1st study. Here are two charts from the respective studies. (see 2nd post for 2nd figure.)

I think the 1st study is prospective and 2nd is retrospective,; generally prospective is preferred.

These very small, and older pre 2017, (2014-2015) studies were busulfan as 2nd line treatment where the regular drugs didn't work.

The 1st study includes Dr Silver as an author.

The 1st chart is quite impressive. The 2nd one less so but still shows Bu having an effect. 2nd one was for a shorter period I believe.

ncbi.nlm.nih.gov/pmc/articl...

researchgate.net/publicatio...

I don't think modern Drs Rx this drug any more, but might be worth asking our Drs about it if just for an opinion. Could it be good in an INF combo? My thought as I've posted is something undetermined as of now combined with INF is likely to be worthy.

[EPguy]

2nd Fig.

Bu 2nd Study

[hunter5582]

Not that I looked too extensively at busulfan, but I would say that it is regarded as a third-line treatment option. It goes beyond its potential leukemogenic potential.

Serious Reactions

myelosuppression

aplastic anemia

febrile neutropenia

sepsis

pneumonia

interstitial pulmonary fibrosis

bronchopulmonary dysplasia

cellular dysplasia

hepatotoxicity

hepatic veno-occlusive dz

thrombotic microangiopathy

arrhythmia

AV block, complete

endocardial fibrosis

cardiac tamponade

seizures

encephalopathy

hemorrhage, severe

tumor lysis syndrome

exfoliative dermatitis

erythema multiforme

erythema nodosum

secondary malignancy

infertility

cataracts

Common Reactions

neutropenia

thrombocytopenia

nausea

vomiting

stomatitis

anorexia

diarrhea

fever

electrolyte abnormalities

abdominal pain

anemia

headache

hyperglycemia

rash

asthenia

LFTs elevated

rigors

tachycardia

dyspepsia

constipation

HTN

edema

lung disorder

thrombosis

dizziness

cough

pruritus

hypersensitivity rxn

chest pain

xerostomia

injection site inflammation

vasodilation

epistaxis

dyspnea

back pain

depression

Cr incr.

amenorrhea

sterility

hyperpigmentation

hyperuricemia

[EPguy in reply to hunter5582]

I also assumed it was plenty toxic but that is quite a list. One of these reports says lower doses may help reduce that. But I would not want it in me unless there is some compelling new info.

In this site, the serious effect of Bu and HU are similar I think.

medlineplus.gov/druginfo/me...

Just for curiosity how does HU look on the source you have?

I posted a while ago about the pre-clinical studies on ATO-INF which showed powerful results. Studies are planned on this combo as below. But I've read that ATO is itself an MPN promoter. Maybe Bu could be something similar in a combo? If the experts aren't going there so far then probably not.

healthunlocked.com/mpnvoice...

<<These results have led to the planning of IFN and arsenic based

clinical trial approaches for MPN patients>>

[hunter5582 in reply to EPguy]

I use ePocrates as my initial source, which is where the citation came from.

Here is the list for HU. I would say that busulfan is more toxic than HU.

Serious Reactions

myelosuppression

leukopenia

anemia

thrombocytopenia

hemolytic anemia

macrocytosis

secondary leukemia (long-term use)

skin CA (long-term use)

infection

vasculitic ulcer

gangrene

dermatomyositis

lupus erythematosus

radiation recall rxn

mucositis, severe

pancreatitis

hepatotoxicity

peripheral neuropathy

fever

hallucinations

seizures

interstitial lung dz

pulmonary fibrosis

pneumonitis

renal impairment

tumor lysis syndrome

male infertility

Common Reactions

myelosuppression

stomatitis

infection

anorexia

nausea

vomiting

diarrhea

constipation

rash

skin ulcer

peripheral erythema

facial erythema

nail hyperpigmentation (long-term use)

skin hyperpigmentation (long-term use)

nail atrophy (long-term use)

skin atrophy (long-term use)

scaling

alopecia

renal impairment

ALT or AST elevated

headache

drowsiness

fever

rigors

dizziness

asthenia

edema

dyspnea

erythrocyte abnormalities

arthralgia

cough

abdominal pain

weight gain

fatigue

back pain

extremity pain