BUSULFAN CONCENTRATION IN RELATION TO PERMANENT ALOPECIA IN RECIPIENTS OF BONE-MARROW TRANSPLANTS

Alopecia is an important long-term complication after bone marrow tran splantation (BMT), The aim of this study was to analyze the influence of busulfan concentration on the development of permanent alopecia, Si xty five patients who survived for at least 6 months after BMT were st udied, The median follow-up was 2.1 years (range 0.5-5.7 years), Thirt y one patients (47%) had some degree of alopecia and 19 of these patie nts had extensive alopecia, The mean minimum busulfan concentration wa s 656 +/- 222 ng/ml in patients who developed alopecia compared with 5 07 +/- 224 ng/ml in those who did not (P = 0.005), Patients with more extensive alopecia had higher busulfan concentrations than patients wi th less significant abnormalities, In multivariate analysis, alopecia was associated with busulfan concentrations higher than the median (OR 3.43; 95% CI 3.04-3.88), allogeneic transplantation (OR 2.56; 95% CI 2.28-2.88) and female sex (OR 1.96; 95% CI 1.73-2.88), There was no as sociation between alopecia and chronic graft-versus-host disease, High busulfan concentrations may contribute to the development of permanen t alopecia and the risk for alopecia should be considered when choosin g the conditioning regimen before BMT.