The alkylating agent busulfan has great utility for patients undergoing hematopoietic cell transplant (HCT). Typically combined with cyclophosphamide or fludarabine/clofarabine, busulfan can help kill cancer cells, enable new blood stem cells to grow in patients’ bone marrow, and prevent rejection of newly transplanted cells.

Properly calibrating busulfan, however, can be a dangerous challenge. Too little may result in rejection of new stem cells, while too much can cause regimen-related toxicity that may result in a host of serious disorders.

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