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HelpTest ID BUAUC Busulfan, Intravenous Dose, Area Under the Curve (AUC), Plasma
Useful For
Guiding dosage adjustments to achieve complete bone marrow ablation while minimizing dose-dependent toxicity
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| DOSE | Busulfan, IV Dose, AUC, P | No | Yes |
| BU2H | Busulfan, Immediate Post Infusion | No | Yes |
| BU3H | Busulfan, 1hr Post Infusion | No | Yes |
| BU4H | Busulfan, 2hr Post Infusion | No | Yes |
| BU6H | Busulfan, 4hr Post Infusion | No | Yes |
Special Instructions
Method Name
Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS)
Reporting Name
Busulfan, IV Dose, AUC, PSpecimen Type
Plasma Na HeparinFour plasma specimens with different draw times (keep all specimens under 1 order) and a completed Busulfan Information: Mail-In Specimen Instructions (T559) are required.
Collection Container/Tube: Green top (sodium heparin)
Submission Container/Tube: Plastic vials
Specimen Volume: 1 mL
Collection Instructions:
1. The first specimen should be drawn immediately after termination of intravenous infusion of 0.8 mg/kg busulfan.
2. Additional specimens should also be drawn at 1 hour, 2 hours, and 4 hours after termination of infusion.
3. Label each specimen appropriately (exact time of draw).
4. Busulfan degrades quickly at room temperature. Each specimen should be kept in wet ice slurry or refrigerated at 4° C. Specimen should be centrifuged as soon as possible after collection. Separate the plasma from each specimen and transfer it to individual 5-mL plastic tubes. Immediately freeze these plasma specimens at -20° C.
Forms: Busulfan Information: Mail-In Specimen Instructions (T559) in Special Instructions
Specimen Minimum Volume
0.25 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Plasma Na Heparin | Frozen (preferred) | 28 days |
| Refrigerated | 72 hours |
Clinical Information
Busulfan is an alkylating agent used to ablate bone marrow cells prior to hematopoietic stem cell transplantation for chronic myelogenous leukemia.(1) Busulfan is typically administered intravenously (IV) at the recommended dosage of 0.8 mg/kg of actual or ideal body weight (whichever is lower) and given once every 6 hours over 4 days for a total of 16 doses. Dose-limiting toxicity of busulfan includes veno-occlusive liver disease, seizures, and coma. To avoid toxicity while ensuring busulfan dose adequacy to completely ablate the bone marrow, IV dosing should be guided by pharmacokinetic (PK) evaluation of area under the curve (AUC) and clearance after the first dose.(2) The PK evaluation should be carried out at the end of the first dose, with results of PK testing available to facilitate dose adjustment before beginning the fifth dose.
Reference Values
AREA UNDER THE CURVE
900-1,500 (mcmol/L)(min)
CLEARANCE
2.1-3.5 (mL/minute)/kg
Cautions
This assay requires 4 plasma specimens. Each specimen must be drawn at the intervals described above and labeled with the exact draw time. The specimen accession times should reflect these times. The time the drug administration is started and terminated, the patient's dose (mg every 6 hours), body weight (kg), and age (years) must be submitted with the specimens. Without infusion start time, exact time of specimen draw, dose, and body weight, the area under the curve and clearance cannot be calculated. Age is required for assessment of the correct dose per body weight.
Day(s) Performed
Monday through Saturday; 2 p.m.
Report Available
Same day/1 dayPerforming Laboratory
Mayo Medical Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.CPT Code Information
80299 x 4