Busulfan clearance in renal failure and hemodialysis

The impact of hemodialysis on the clearance of busulfan was determined in a patient with chronic renal failure undergoing autologous peripheral stem c ell transplantation for non-Hodgkin's lymphoma. The extraction ratio for bu sulfan across the dialyzer was 0.530 +/- 0.026 at a blood flow of 400 ml/mi n, which corresponds to a hemodialysis clearance of 2.23 +/- 0.11 ml/min/kg body weight. Apparent oral clearance of busulfan without hemodialysis was 3.38 +/- 0.56 ml/min/kg, Thus, a 4 h hemodialysis session enhanced the appa rent oral clearance of busulfan by 65%, We conclude that hemodialysis effec tively removes busulfan from circulating blood, but a standard hemodialysis period (ie, 4 h) does not significantly alter busulfan exposure.