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Lorazepam for seizure prophylaxis during high-dose busulfan administration
K W Chan1, C A Mullen, L L Worth
1Division of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Bone Marrow Transplantation
|July 5, 2002
Summary
Lorazepam is an effective seizure prophylaxis during high-dose busulfan therapy in children undergoing stem cell transplantation. This regimen was well-tolerated, with no seizures observed and no impact on busulfan pharmacokinetics.
Area of Science:
- Pharmacology
- Hematology
- Pediatric Oncology
Background:
- High-dose busulfan (BU) therapy can cause seizures, a serious complication.
- Phenytoin (DPH) is a common prophylactic agent but has adverse effects and may affect BU metabolism.
Purpose of the Study:
- To evaluate lorazepam as an alternative for seizure prophylaxis during high-dose BU therapy in pediatric hematopoietic stem cell transplantation (HSCT).
Main Methods:
- Twenty-nine children undergoing HSCT received lorazepam (median dose 0.022 mg/kg) intravenously or orally for seizure prophylaxis during BU treatment.
- Pharmacokinetic studies were conducted concurrently.
Main Results:
- The lorazepam regimen was well-tolerated, with drowsiness as the primary side effect.
- No seizures occurred during or within 48 hours of BU therapy.
- Twelve patients received oral lorazepam prophylaxis.
- Lorazepam did not alter BU absorption or clearance.
Conclusions:
- Lorazepam is a safe and effective alternative for seizure prophylaxis in children receiving high-dose busulfan therapy for HSCT.
- This approach avoids potential adverse effects and drug interactions associated with phenytoin.