ArticleFrontiers in pharmacology2025
Semi-mechanistic population pharmacokinetic model incorporating glutathione S-transferase activity for personalized busulfan dosing in pediatric allogeneic hematopoietic cell transplantation.
Article in Frontiers in pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- From Therapeutic Drug Monitoring to Model-Informed Precision Dosing: A Review of Busulfan Dosing Optimization in Pediatric Hematopoietic Stem Cell Transplantation.Pharmaceutics · 2026Review
- Population pharmacokinetic modeling of tacrolimus using real-world data for precision dosing in pediatric liver transplant recipients younger than 36 months during the immediate postoperative period.Frontiers in pharmacology · 2026Article
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12 authors.
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Abstract
Background: Busulfan is known for its high inter- and intra-individual pharmacokinetics/pharmacodynamics (PK/PD) variability, especially in children. Therefore, we aimed to identify factors affecting PK variability of busulfan in pediatric allogeneic hematopoietic cell transplantation (HCT) recipients and investigate the effect of glutathione S-transferase (GST) activity on busulfan metabolism using a semi-mechanistic population PK model. Methods: Overall, 636 whole-blood busulfan concentrations from 65 pediatric HCT recipients were analyzed using nonlinear mixed-effects modeling. A semi-mechanistic population PK model was developed to describe busulfan metabolism in response to glutathione (GSH) depletion. The effects of potential covariates were selected based on previous study and physiologically-based theoretical mechanisms. Virtual clinical trials were conducted to compare different dosing strategies, and model-based optimal dosing regimen was recommended. Results: A two-compartment model with first-order absorption was selected to describe busulfan PK. A GSH compartment was added to represent the relative amount of GSH available at any time. The estimated mean clearance of busulfan was 9.57 L h Conclusion: NFM, age-dependent maturation function, and GST enzyme activity may contribute to busulfan PK variability. The WT-based dosing strategy showed a higher risk of SOS than the age-based dosing strategy in 9-16 kg patients.
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