Related Experiment Video
Updated: Aug 18, 2026
Busulfan as a Myelosuppressive Agent for Generating Stable High-level Bone Marrow Chimerism in Mice
Published on: April 1, 2015
Growth in children undergoing bone marrow transplantation after busulfan and cyclophosphamide conditioning
S M Shankar1, N J Bunin, T Moshang
1Division of Oncology, Children's Hospital of Philadelphia, PA 19104, USA.
Insights
Busulfan and cyclophosphamide (BUCY) conditioning before bone marrow transplantation (BMT) did not result in growth failure in children. Post-transplant growth assessments showed no significant differences compared to pre-transplant measurements.
Area of Science:
- Pediatric Oncology
- Hematology
- Endocrinology
Background:
- Bone marrow transplantation (BMT) is a critical treatment for various pediatric hematologic and oncologic conditions.
- Conditioning regimens, such as busulfan and cyclophosphamide (BUCY), are essential for successful BMT but can potentially impact long-term growth.
- Evaluating the effects of conditioning regimens on pediatric growth is crucial for optimizing post-transplant outcomes.
Purpose of the Study:
- To assess the impact of busulfan and cyclophosphamide (BUCY) conditioning on the growth of children undergoing bone marrow transplantation (BMT).
- To compare pre-BMT height and growth rates with measurements taken 1, 2, and 3 years post-BMT.
Main Methods:
- Prospective growth assessment of 25 children who received BUCY conditioning for BMT.
- Height and growth rates were measured as standard deviation scores (SDS) and compared pre- and post-BMT.
- Hormonal (IGF-1, IGFBP-3) and thyroid function, along with bone age, were evaluated.
Main Results:
- No statistically significant differences were observed in height SDS at 1, 2, or 3 years post-BMT compared to pre-BMT.
- Growth rate SDS at 1 and 2 years post-BMT did not show significant changes.
- All assessed hormonal levels and thyroid functions were normal, and bone age was appropriate for age.
Conclusions:
- Busulfan and cyclophosphamide (BUCY) conditioning prior to BMT does not appear to cause significant growth failure in pediatric patients.
- The findings suggest that BUCY conditioning is a safe regimen concerning long-term growth in this population.
- Further research may explore growth patterns in larger cohorts or with different conditioning agents.
Purpose:
The purpose of this study was to evaluate the effect of busulfan and cyclophosphamide (BUCY) as conditioning regimen for bone marrow transplantation (BMT) on growth of children following BMT.
Patients And Methods:
Growth assessment was prospectively done in all 25 children who underwent BMT following BUCY conditioning from 1989 to 1994 at Children's Hospital of Philadelphia. The height and growth rates were expressed as standard deviation scores (SDS). The height SDS prior to BMT were compared with 1, 2, and 3 years post-BMT. The growth rate SDS 1 year and 2 years post-BMT were also compared. Pubertal children were excluded from the analysis of growth rate. Median age of patients was 7 years (range, 1.3-15 years). A total of 22/25 patients were transplanted for AML, and three patients had myelodysplastic syndrome. Equal numbers of patients had autologous and allogeneic transplants. Seven patients received corticosteroids for varying lengths of time. The pre-BMT height SDS (mean +/- SD) for the group was -0.4 +/- 1.3. The mean height SDS for 19 children at 1 year post-BMT was +/- 0.1 +/- 1.2 and for 10 children, 2 years post-BMT was -0.3 +/- 1.6. Seven children who were 3 years post-BMT had the mean height SDS of -0.2 +/- 1.5. There was no statistically significant difference between pre-BMT height SDS and 1 year post-BMT (p = 0.49) and 2 years post-BMT (p = 0.42). The mean growth rate at 1 year post-BMT was -0.1 +/- 2.7 and at 2 years post-BMT was -0.9 +/- 2.3. The difference was not statistically different (p = 0.15). Somatomedin-C (insulin growth factor 1, IGF-1) levels were normal in all 13 children tested at 1 year post-BMT. IGF binding protein (BP)-3 levels were done in 10 children at 1 year and were found to be normal in all. Thyroid function studies were done in all patients pre-BMT and 1 year post-BMT and were normal for all. Bone age assessment was appropriate for age in all 14 patients tested at 1 year post-BMT.
Conclusions:
There was no evidence of growth failure following BMT with BUCY conditioning in this group of patients.
Related Concept Videos
01:21Stem Cell Therapy for Tissue Regeneration
Types of Stem Cells used in Stem Cell Therapy
The two main cell types that...
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy the...