{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T17:22:28Z","timestamp":1791393748661,"version":"4.3.3"},"reference-count":26,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceutics"],"abstract":"<jats:p>Background\/Objectives: Busulfan is a key component of myeloablative conditioning regimens in hematopoietic stem cell transplantation (HSCT) for pediatric patients with acute myeloid leukemia, solid tumors, and certain non-malignant diseases. This study compares the clinical outcomes of once-daily (BU1) versus four-times-daily (BU4) busulfan dosing regimens in pediatric HSCT recipients. Methods: A retrospective analysis was conducted on 70 pediatric patients who underwent HSCT at Hadassah Medical Center between June 2018 and October 2023. Thirty-five patients received the BU4 regimen, and 35 received BU1. The primary endpoint was 100-day event-free survival (EFS). Results: There was no statistically significant difference in 100-day event-free survival between the BU1 group (88.6%) and the BU4 group (85.7%; p = 0.768). Similarly, no significant differences were found in time to neutrophil engraftment (p = 0.251) or platelet engraftment (p = 0.688). Sinusoidal obstruction syndrome (SOS) occurred in 17.1% of patients in each group. No significant differences were observed in the increase in liver enzyme levels (p = 1.0). The incidence of acute graft-versus-host disease was comparable between the groups (41.9% for BU1 vs. 40.0% for BU4; p = 0.878). Conclusions: Once-daily and four-times-daily busulfan regimens demonstrated comparable clinical outcomes in terms of efficacy and adverse events. Further prospective studies are needed to validate these findings.<\/jats:p>","DOI":"10.3390\/pharmaceutics17081081","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T14:46:04Z","timestamp":1755787564000},"page":"1081","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Once-Daily Versus Four-Times-Daily Intravenous Busulfan with Therapeutic Drug Monitoring as Conditioning for Hematopoietic Cell Transplantation in Children"],"prefix":"10.3390","volume":"17","author":[{"given":"Safaa","family":"Bazbaz","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy, School of Pharmacy, Faculty of Medicine, Hebrew University of Jerusalem, P.O.Box 12272, Jerusalem 9112102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Zaidman","sequence":"additional","affiliation":[{"name":"Hadassah Medical Center, Faculty of Medicine, Department of Bone Marrow Transplantation and Cancer Immunotherapy, Hebrew University of Jerusalem, P.O.Box 12000, Jerusalem 91120, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4292-6376","authenticated-orcid":false,"given":"Ehud","family":"Even-Or","sequence":"additional","affiliation":[{"name":"Hadassah Medical Center, Faculty of Medicine, Department of Bone Marrow Transplantation and Cancer Immunotherapy, Hebrew University of Jerusalem, P.O.Box 12000, Jerusalem 91120, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Polina","family":"Stepensky","sequence":"additional","affiliation":[{"name":"Hadassah Medical Center, Faculty of Medicine, Department of Bone Marrow Transplantation and Cancer Immunotherapy, Hebrew University of Jerusalem, P.O.Box 12000, Jerusalem 91120, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Razan","family":"Sakran","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology and Toxicology Section, Rambam Health Care Campus, P.O.Box 9602, Haifa 3109601, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8462-7673","authenticated-orcid":false,"given":"Daniel","family":"Kurnik","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology and Toxicology Section, Rambam Health Care Campus, P.O.Box 9602, Haifa 3109601, Israel"},{"name":"Rappaport Faculty of Medicine, Technion\u2013Israel Institute of Technology, Haifa 3200003, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gefen","family":"Aldouby-Bier","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, School of Pharmacy, Faculty of Medicine, Hebrew University of Jerusalem, P.O.Box 12272, Jerusalem 9112102, Israel"},{"name":"Hadassah Medical Center, Faculty of Medicine, Department of Bone Marrow Transplantation and Cancer Immunotherapy, Hebrew University of Jerusalem, P.O.Box 12000, Jerusalem 91120, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1002\/psp4.12809","article-title":"Population pharmacokinetic model for once-daily intravenous busulfan in pediatric subjects describing time-associated clearance","volume":"11","author":"Lawson","year":"2022","journal-title":"CPT Pharmacomet. 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