Personalized dosing of busulfan for children undergoing stem cell transplants

Implementing Pharmacogenetics in the Busulfan Dosing Method for Children Undergoing Hematopoietic Stem-cell Transplantation: a Prospective, Multicentric, Randomized Clinical Trial

Not applicable Interventional University Hospital, Geneva · NCT04822532

This study is testing whether giving children and teens a personalized dose of busulfan based on their genetics can make stem cell transplants work better and cause fewer side effects.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment260 (estimated)
AgesN/A to 18 Years
SexAll
SponsorUniversity Hospital, Geneva Academic / other
Drugs / interventionsfludarabine
Locations1 site (Geneva)
Trial IDNCT04822532 on ClinicalTrials.gov

What this trial studies

This clinical trial aims to personalize the dosing regimen of busulfan, a medication used in hematopoietic stem cell transplantation (HSCT), for children and adolescents. Participants will be randomly assigned to receive their initial dose based on either a standard method using age and weight or a method that incorporates genetic factors affecting busulfan metabolism. The goal is to improve the efficacy of HSCT while minimizing related toxicities. The study is being conducted internationally across five countries: Canada, Italy, Switzerland, France, and Denmark.

Who should consider this trial

Good fit: Ideal candidates are children and adolescents aged 0-18 years who require allogeneic or autologous HSCT and are eligible for busulfan-based conditioning regimens.

Not a fit: Patients who are scheduled to receive certain medications that interact with busulfan during the conditioning period may not benefit from this study.

Why it matters

Potential benefit: If successful, this approach could lead to more effective and safer HSCT treatments for children and adolescents.

How similar studies have performed: Other studies have shown promise in using pharmacogenetic approaches for drug dosing, suggesting potential success for this personalized method.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* Patients must be aged from 0-18 years old on entry to the study;
* Clinical indication of allogeneic or autologous hematopoietic stem cell transplantation;
* The conditioning protocol must include IV Bu formulations, Busulfex® (Otsuka Pharmaceutical), Busilvex® (Pierre Fabre Pharma) or other European Medicines Agency (EMA) or Food and Drugs Administration (FDA) approved generic formulations regardless of the administration schedule (q6h, q12h, or q24h)
* The expected length of time from recruitment to starting the conditioning regimen must be superior to 10 days;
* Informed written consent to participate in the study signed by the participant/parent

Exclusion Criteria:

• At least one of the drugs listed below scheduled to be administered in the Bu administration days up to 24h after the last dose of Bu, whenever a washout is not possible:

* Metronidazol (required washout: 7 days)
* Nalidixic acid (required washout: 7 days)
* Phenytoin (required washout: 21 days)
* Itraconazole (required washout: 14 days)
* Ketoconazole (required washout: 7 days)
* Voriconazole (required washout: 7 days)
* Deferasirox (required washout: 7 days)

Where this trial is running

Geneva

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Hematopoietic Stem Cell TransplantationAllogeneic Hematopoietic Stem Cell TransplantationAutologous Hematopoietic Stem Cell TransplantationPrecision dosingPharmacogeneticsChildrenAdolescentBusulfan
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.