Busulfan is a chemotherapy medicine used before bone marrow transplant or high dose therapy with stem cell rescue to help treat certain types of cancer and metabolic conditions.
How is busulfan given?
Busulfan can be given by mouth, through a nasogastric or gastrostomy tube (orally) or as an infusion into a vein (intravenously) through a central venous catheter, implantable port or PICC. It is usually given four times a day for four days. If busulfan is given by mouth or through a nasogastric or gastrostomy tube, your child will not be allowed to eat (nil by mouth) for two hours before and for half an hour after each dose.
What are the side effects of busalfan?
Nausea and vomiting
Anti-sickness drugs can be given to reduce or prevent these symptoms, although this may not be allowed in some treatment protocols. Please tell your doctor or nurse if your child’s sickness is not controlled or persists.
Bone marrow suppression
There will be a temporary reduction in how well your child’s bone marrow works. This means your child may become anaemic, bruise or bleed more easily than usual, and have a higher risk of infection. Your child’s blood counts will be checked regularly to see how the bone marrow is working. Please tell your doctor if your child seems unusually tired, has bruising or bleeding, or any signs of infection, especially a high temperature.
Mouth sores and ulcers
Your child may get painful or bleeding gums, ulcers or a sore mouth. You will be given advice about appropriate mouth care including a copy of the mouth care leaflet. If your child complains of having a sore mouth, please tell your doctor or nurse.
Diarrhoea
If your child has a sore mouth, he or she will often have a sore tummy too. This can cause pain and bloating as well as diarrhoea. Please tell the doctor or nurse if your child has diarrhoea that is not controlled or persists. It is important that your child drinks lots of fluids.
Hair Loss
Your child may lose some or all of his or her hair, including eyebrows and eyelashes. This is temporary and the hair will grow back once the treatment has finished.
Skin discolouration
Busulfan may cause your child’s skin to develop a darker colour. This is usually temporary and should disappear once treatment has finished.
Liver function
Busulfan can sometimes cause significant changes to your child’s liver function. This should return to normal when the treatment is finished. Blood tests will be taken to monitor your child’s liver function and his or her weight and tummy measurement will be recorded. If you notice the whites of your child’s eyes or their skin becoming yellow, please let your doctor or nurse know immediately.
Lung problems
Busulfan may cause changes to the lung function. If your child develops a cough, has difficulty breathing or chest pain, please tell your doctor or nurse immediately.
Fits or Seizures
There is a small risk that your child may have a fit or seizure during busulfan treatment. If your child is thought to be at risk, medicine will be given to help stop this from happening.
Fertility
Depending on the combination of medicines and the dose that your child is given, his or her fertility may be affected. If you feel you would like more information, please discuss this with your doctor.
Secondary cancers
There is a very small risk of your child developing a second cancer after many years. If you would like more information, please discuss this with your doctor.
Busulfan and interactions with other medicines
Some medicines can react with busulfan, altering how well it works. Always check with your doctor or pharmacist before giving your child any other medicine, including medicines on prescription from your family doctor (GP), medicines bought from a pharmacy (chemist) or any herbal or complementary medicines.
Last reviewed by Great Ormond Street Hospital: November 2009
Ref: 09F0782 © GOSH Trust November 2009
Compiled by the Pharmacy department in collaboration with the Child and Family Information Group
Please read this information in conjunction with any patient information leaflet provided by the manufacturer. However, please note that this information explains about the use of medicines in children and young people so may differ from the manufacturer’s information.
Each person reacts differently to medicines so your child will not necessarily suffer every side effect mentioned. This information does not constitute health or medical advice and will not necessarily reflect treatment at other hospitals. If you have any questions, please ask your doctor. No liability can be taken as a result of using this information.
