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Cancers & treatments·Regimen libraryConditioning

BuMel (busulfan, melphalan) high-dose conditioning

Checked 2026-09-09

High-dose chemotherapy before autologous stem cell rescue in high-risk neuroblastoma (SIOPEN HR-NBL1)

Also called BuMel, Busulfan-melphalan.

One cycle

weekly × 1 · about 1 weeks in total
1234567Busulfan: dosed by weight band, 16 doses over four days (days -6 to -3), IntravenousBusulfanMelphalan: 140 mg/m², IntravenousMelphalan
7-day cycle × 1 (about 1 weeks)Intravenous

Components

DrugDoseRouteDays
Busulfan
Alkylating agent (alkyl sulfonate)
dosed by weight band, 16 doses over four days (days -6 to -3)IVD1-4
Melphalan
Alkylating agent (nitrogen mustard)
140 mg/m²IVD5
Cycles
1
7-day cycle
Emetogenicity
High (>90%)
G-CSF
Built into the protocol

Notes

  • BuMel gave better event-free survival and less severe toxicity than CEM, so it became the European standard conditioning for high-risk neuroblastoma.
  • Stem cells are reinfused on day 0; veno-occlusive disease is the specific risk of busulfan and is monitored closely.

Used in

Neuroblastoma (paediatric)
Products
BusulfanMelphalan (including hepatic delivery system)

Source

Ladenstein (HR-NBL1/SIOPEN), Lancet Oncology 2017: busulfan and melphalan versus CEM

Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.

Other regimens for these cancers

CEM (carboplatin, etoposide, melphalan) high-dose conditioning
High-dose chemotherapy before autologous stem cell rescue in high-risk neuroblastoma, the Children's Oncology Group standard compared against BuMel in HR-NBL1
weekly × 1
All regimensCEM (carboplatin, etoposide, melphalan) high-dose conditioning →