Test Guide Mobile

Busulphan

Blood
Test performed by: LabPLUS Toxicology

It is ESSENTIAL that the ward liaises with the laboratory prior to collecting the samples. For pre-arrangement, please contact: Lablink on ext 22000.

Specimen Requirements:

Timed samples after the end of the 2-hour infusion (once-a-day regime):

15 mins (T 2.25) , 1 hour (T3), 2 hours (T4), 6 hours (T8). All samples are required.

Record collection times ACCURATELY on the individual specimen request form. Special Busulphan TDM request forms should be used ( obtainable through Chromatography section at Labplus).

For same day results, the final specimen must be received at the laboratory by 7:30am.

IMPORTANT:

Samples to be centrifuged, separated, and frozen within 2 hrs of collection.

Specimen Collection
Gel tubes are NOT acceptable

4 mL Adult Heparin Blood (Always Required)
Reference Intervals
After consultation with Auckland Hospital paediatric and adult haematologists, the target area under the plasma concentration curve (AUC) for once daily regime has been set at 22.5 mg*hr /L with an acceptable range . A set of 4 timed plasma samples (2 hours 15 mins, 3 hours, 4 hours and 8 hours from start of the 2 hours infusion) is collected usually after the Day 1 dose. Using DoseMe RX software, a predicted dose is calculated and provided to the attending haematologist to guide subsequent dose. A dose prediction report will be uploaded to RCP and emailed to Pharmacy and SMO.

Uncertainty of measurement: 10%

Turnaround Time: Within 1 day
Test not available outside normal working hours unless pre-arranged with Toxicology.

Diagnostic Use and Interpretation
Busulphan is an alkylating agent used in preparation for bone marrow transplantation of patients with haematological conditions. There is wide intra- and inter-patient variation in its disposition, metabolism, and clearance. Therefore, individualized therapeutic drug monitoring is performed to ensure optimal busulfan dosing to reduce risk for graft rejection or disease relapse while at low risk for toxicity including hepatic sinusoidal obstruction syndrome.

Contact Information
Emails to chemicalpathologist@adhb.govt.nz will receive priority attention from the on-call chemical pathologist.
If the query concerns a specific patient please include the NHI number in your email.

If email is not a suitable option, please contact the on-call chemical pathologist via Lablink (Auckland City Hospital ext. 22000 or 09-3078995).

Individual chemical pathologists may be contacted but will not be available at all times.

After-hours : contact Lablink (Auckland City Hospital ext. 22000 or 09-3078995) or hospital operator for on duty staff after hours.

Dr Samarina Musaad (Clinical Lead) : SamarinaM@adhb.govt.nz ext. 22402

Dr Cam Kyle: CampbellK@adhb.govt.nz ext 22052

Dr Weldon Chiu: WeldonC@adhb.govt.nz ext. 23427

Dr Campbell Heron: CHeron@adhb.govt.nz ext. 23427

Dr Sakunthala Jayasinghe: Sakunthala@adhb.govt.nz ext. 23427

For further information please contact the laboratory or:
Dr Hima Madhavaram, Toxicology Scientific Specialist: ext. 22057

Specimen Transport Instructions for Referring Laboratories
This test is done by pre-arrangement only. Please contact LabPlus Toxicology Laboratory, (09)307 4949 ext. 22057 or 22051.

Last updated at 12:00:58 28/02/2025