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Two-Sample 3-and-7-Hour Schedule Optimizes Once-Daily Busulfan TDM

busulfanalkylating agenthematopoietic stem cell transplantationtherapeutic drug monitoringmodel-informed precision dosinglimited sampling strategypopulation pharmacokineticssimulation studyAUC targeting Pharmacokinetics / TDM

Background Information

Enhance busulfan dosing with a precise two-sample strategy.

Busulfan has a narrow therapeutic index and high pharmacokinetic variability, making precise dosing critical in hematopoietic stem cell transplantation. A two-sample strategy at 3 and 7 hours post-infusion was most effective, doubling target attainment compared to a single-sample method. This study offers evidence for an optimal sampling strategy in therapeutic drug monitoring for busulfan, essential for improving dosing accuracy. A two-sample strategy significantly enhances busulfan target attainment in transplantation settings.

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Authors: Tan Z, Achini-Gutzwiller FR, Lankester AC, van der Hem JGK, von dem Borne PA, Moes DJAR, Preijers T

Citation: Tan Z, Achini-Gutzwiller FR, Lankester AC, et al. Simulation-Based Evaluation of Busulfan Sampling Strategies in Adults and Adolescents Undergoing Allogeneic Hematopoietic Stem Cell Transplantation. Journal of clinical pharmacology. 2026;66(9):e70281. doi:10.1002/jcph.70281

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

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