Busulphan

It is an alkylating agent which is highly specific for myeloid elements; granulocyte precursrs being most sensitive, followed by those of platelets and R.B.C. It produces little effect on lymphoid tissue and G.I.T.

Indications

Myelofibrosis, chronic granulocytic leukaemia, polycythaemia vera, essential thrombocythaemia. chronic myeloid leukemia.

Dosage

2-6 mg/day (0.06 mg/kg/day) orally.

Contra-Indications

Bone marrow suppression, chronic lymphocytic leukaemia, acuteleukaemia, doubtful CML diagnosis, CML blast crises.

Special Precautions

Pregnancy, lactation. Therapy should be initiated after hospitalization;

Side Effects

Hyperuricaemia, pulmonary fibrosis. Bone marrow suppression, hyperpigmentation.

Drug Interactions

Combination with thioguanine results in nodular regenerative hyperplasia, portal, hypertension, varices. Cyclophosphamide enhances haemopoetic recovery. Immunisation with live viruses can cause life threatening infection.