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Accidental busulfan overdose: enhanced drug clearance with hemodialysis in a child with Wiskott-Aldrich syndrome

Bone Marrow Transplantation volume 27, pages 551–553 (2001)Cite this article

Abstract

A 4.6 kg infant with Wiskott-Aldrich syndrome received an accidental overdose of busulfan during preparation for allogeneic stem cell transplantation. Pharmacokinetic analysis of plasma busulfan levels alerted staff to the dosing error. Hemodialysis was immediately performed and resulted in accelerated clearance of busulfan. There were no acute neurologic and hepatic side-effects of the busulfan overdose, and despite 2 months of cough accompanied by rales, the patient is now free of pulmonary symptoms. Stable partial donor chimerism occurred after transplantation. At present, the patient is thriving and infection-free 12 months after transplantation, although his platelet count remains at the lower limit of normal. Bone Marrow Transplantation (2001) 27, 551–553.

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Acknowledgements

The authors are indebted to Prof JT Slattery from the Fred Hutchinson Center of Cancer Research (Seattle, WA, USA) for his valuable advice.

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Authors and Affiliations

  1. Department of Pediatric Hematology Oncology, Bone Marrow Transplantation Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    J Stein & I Yaniv

  2. Division of Pediatric Nephrology, Schneider Children's Medical Center of Israel, Petah Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    M Davidovitz & Z Gamzu

  3. Division of Intensive Care, Schneider Children's Medical Center of Israel, Petah Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    J Ben-Ari

  4. Clinical Pharmacology Unit, Rambam Medical Center, Israel Institute of Technology–Technion, Haifa, Israel

    E Hoffer, Y Bentur, A Tabak & N Krivoy

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  1. J Stein
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Stein, J., Davidovitz, M., Yaniv, I. et al. Accidental busulfan overdose: enhanced drug clearance with hemodialysis in a child with Wiskott-Aldrich syndrome. Bone Marrow Transplant 27, 551–553 (2001). https://doi.org/10.1038/sj.bmt.1702801

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