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Busulfan

Bus-sultan
Picmonic
Busulfan is an alkylating anticancer agent that is used to treat CML, and as a conditioning agent prior to bone marrow transplantation. As an alkylating agent, it works to cross-link DNA. Side effects of busulfan use include myelosuppression, pulmonary fibrosis and hyperpigmentation.
6 KEY FACTS
INDICATIONS
CML
CaMeL

Busulfan is used to treat CML (chronic myelogenous leukemia), and is used because of its low cost. The gold standard of treatment for CML, now, is imatinib.

Bone Marrow Ablation
Bone Arrow Baster

This drug is used to ablate patient's bone marrow, and is indicated as a conditioning agent prior to bone marrow transplantation, especially patients with CML.

MECHANISM
Cross-links DNA
Linked DNA

Busulfan is an alkylating agent that forms DNA-DNA intrastrand crosslinks. This prevents DNA replication, as these crosslinks cannot be repaired by cellular machinery, causing the cancer cell to undergo apoptosis.

SIDE EFFECTS
Myelosuppression
Suppressed Red and White blood cells

This drug leads to severe myelosuppression, hence its use as an ablation agent.

Pulmonary Fibrosis
Fiber-ball hitting Lungs

The most notable toxicity of this medication is interstitial pulmonary fibrosis, leading to the term "Busulfan lung."

Hyperpigmentation
Hiker-pig with Hyperpigmentation

Patients can develop skin hyperpigmentation with the use of Busulfan. The presentation of this skin manifestation mimics Addison disease, affecting the joints and skin creases as bronzing.

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