Chemotherapy Patient Resource Area

Busulfan/Myleran^®

Drug
Busulfan (generic name) is manufactured as Myleran^® (trade name) (GlaxoSmithKline, Research Triangle Park, NC).

Action
Busulfan slows or stops the growth of cancer cells. It is a type of drug called an alkylating agent and is used to treat chronic myeloid leukemia. It also is used to treat other disorders that disrupt the way blood cells multiply, such as myeloproliferative disorders, severe thrombocytosis, and polycythemia vera. It is used in combination with other drugs to treat myelofibrosis, and it is used in very high doses as a preparation treatment given to patients undergoing blood and marrow transplantation.

What does the drug look like?
Busulfan is supplied as small, white, round 2-mg tablets.

How long will I take the drug?
The length of treatment varies and depends on your diagnosis and how well your body responds to treatment.

Storage
Store this medicine at room temperature, away from excess heat and moisture (do not store on a windowsill or in a bathroom). Keep this medicine in its original container, out of the reach of children or pets. Do not keep outdated medication that you no longer need. Ask your nurse or pharmacist how you should dispose of any medicine you do not use.

• Busulfan lowers the number of white blood cells in your blood. Your complete blood count (CBC) will be monitored frequently while you receive this drug. This drug increases your chance of getting an infection. Avoid crowds and people who have infections. Call your doctor immediately if you develop a temperature higher than 100.5^oF or have chills, a cough, or painful urination.
• Busulfan also lowers the number of platelets in your blood, which are necessary for proper blood clotting. DO NOT take aspirin or aspirin-containing products while taking busulfan. Call your doctor immediately if you notice unusual bleeding or bruising, have black or tar-like stools, see blood in your urine, or develop pinpoint red spots on your skin. Use a soft toothbrush, and use care when flossing.
• Busulfan may cause mouth sores. Avoid spicy foods and do not use mouthwash, because it may contain alcohol and worsen mouth pain. Your healthcare providers may give you suggestions on how to care for your mouth or manage mouth sores, and these directions should be followed carefully.
• Busulfan may cause your hair to thin and become brittle.
• Busulfan may cause your skin to be very dry, and some people notice that their skin is darker in color.
• Busulfan may cause loss of appetite and weight loss. If you lose more than three pounds in one week, ask your nurse for suggestions on what to eat.
• While you are being treated with busulfan, do not receive any immunizations (vaccinations), such as flu shots, without your doctor's approval.
• When given to young girls, busulfan may cause ovarian failure and may stop girls from reaching puberty.
• Busulfan may interfere with the normal menstrual cycle (period) in women and may stop sperm production in men. However, you must use a reliable method of birth control and not assume that you cannot get pregnant or get someone else pregnant. Women who are pregnant or would like to become pregnant need to discuss this with their doctors before taking this drug.
• Busulfan has been associated with the development of other types of cancers years after treatment. Discuss this potential risk of developing a new cancer with your doctor.

Drug interactions
When you are taking busulfan, it is important that you let your doctor know if you are taking aspirin, itraconazole, or thioguanine. Also, if you are taking vitamins, herbs, or nutritional supplements, be sure to let your doctor know.

• Temperature (fever) higher than 100.5^oF
• Any signs of infection, such as chills, cough, or burning or pain on urination
• Any bleeding, such as from your nose or gums or in your urine
• Dark-colored (black or tar-like) stools
• Unusual bruising
• Pinpoint red spots on your skin
• Moderate to severe mouth sores or blistering