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Busulfan
Systematic (IUPAC) name
butane-1,4-diyl dimethanesulfonate
Identifiers
CAS number 55-98-1
ATC code L01AB01
PubChem 2478
DrugBank APRD00664
ChemSpider 2384
Chemical data
Formula C6H14O6S2 
Mol. mass 246.304 g/mol
SMILES eMolecules & PubChem
Pharmacokinetic data
Bioavailability 80% (oral)
Protein binding 32.4%
Metabolism Hepatic
Half life 2.5 hours
Excretion  ?
Therapeutic considerations
Licence data

EU EMEA:linkUS FDA:link

Pregnancy cat. D(US)
Legal status Prescription only
Routes Oral, parenteral
 Yes check.svgY(what is this?)  (verify)

Busulfan is a chemotherapy drug that is a cell cycle non-specific alkylating antineoplastic agent (slows the growth of cancer cells). More specifically it belongs to a subclass of alkylating agents known as alkyl sulfonates. It is marketed in the U.S. by GlaxoSmithKline under the brand name Myleran, and has been in clinical use since 1959. Busulfan is also available in an IV formulation marketed as Busulfex by PDL BioPharma, Inc. Its chemical designation is 1,4-butanediol dimethanesulfonate.

Contents

History

Busulfan was the mainstay of the chemotherapeutic treatment of Chronic Myeloid Leukemia (CML) until it was displaced by the new gold standard, Imatinib, though it is still in use to a degree as a result of the drug's relative inexpense.

Indications

Currently, its main uses are in bone marrow transplantation, especially in chronic myelogenous leukemia (CML), where it is used as a conditioning drug. Busulfan can control tumor burden but cannot prevent transformation or correct cytogenic abnormalities. Though not as common, it may also be used for Chronic Lymphocytic Leukemia (CLL). The drug was recently used in a study to examine the role of platelet-transported serotonin in liver regeneration.[1]

Availability

Myleran is supplied in white film coated tablets with 2mg of Busulfan per tablet. it is also used in the treatment of chronic lymphocytic leukemia

Side effects

Toxicity may include interstitial pulmonary fibrosis, hyperpigmentation, seizures, hepatic (veno-occlusive disease) and wasting syndrome. Phenytoin may be used concurrently to prevent the seizures.

1,4-Butanediol dimethanesulfonate is listed by the IARC as a Group 1 carcinogen.

Pharmacology

Its mechanism of action through alkylation produces Guanine-Adenine intrastrand crosslinks.[2] This occurs through an SN2 reaction in which the relatively nucleophilic guanine N7 attacks the carbon adjacent to the mesylate leaving group. This kind of damage cannot be repaired by cellular machinery and thus the cell undergoes apoptosis.[3] Busulfan also induces thrombocytopenia, a condition of lowered blood platelet count and activity.

Complexation

The molecular recognition of ureido-cyclodextrin with busulfan was investigated.[4]. The formation of complexes was observed with electrostatic interactions between urea and the sulfonate part of busulfan. A other structure was used for this complextation type, two disaccharidyl units connected by urea linkers to a diazacrown ether organizing platform [5].

References

  1. ^ Lesurtel M, Graf R, Aleil B, Walther D, Tian Y, Jochum W, Gachet C, Bader M, Clavien P (2006). "Platelet-derived serotonin mediates liver regeneration". Science 312 (5770): 104–7. doi:10.1126/science.1123842. PMID 16601191. 
  2. ^ Iwamoto, T; et al. "DNA intrastrand cross-link at the 5'-GA-3' sequence formed by busulfan and its role in the cytotoxic effect" Cancer Science 2004 95 pp 454-458
  3. ^ Karstens, A; Kramer, I. "Chemical and physical stability of diluted busulfan infusion solutions". EJHP Science 2007 13 pp 40-47
  4. ^ Menuel S, Joly JP, Courcot B, Elysee J, Ghermani NE, Marsura A (2007). "Synthesis and inclusion ability of a bis-beta-cyclodextrin pseudo-cryptand towards Busulfan anticancer agent". TETRAHEDRON 63 (7): 1706–1714. doi:10.1016/j.tet.2006.10.070. 
  5. ^ Porwanski S, Florence DCB, Menuel S, Joly JP, Bulach V, Marsura A (2009). "Bis-beta-cyclodextrinyl- and bis-cellobiosyl-diazacrowns: synthesis and molecular complexation behaviors toward Busulfan anticancer agent and two basic aminoacids". TETRAHEDRON 65 (31): 6196–6203. doi:10.1016/j.tet.2009.05.057. 

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