A Simple and Accurate Liquid Chromatography-Tandem Mass Spectrometry Method for Therapeutic Drug Monitoring of Busulfan in Plasma

Ann Clin Lab Sci. 2019 Mar;49(2):212-217.

Abstract

Objective: Busulfan, frequently used as a conditioning regimen for hematopoietic stem cell transplantation, has a narrow therapeutic range and wide intra-and interpatient variabilities. Therefore, therapeutic drug monitoring of busulfan is necessary to ensure that the drug concentrations of patients are within a targeted therapeutic range. In this study, we developed a simple and accurate method for measuring busulfan concentrations using liquid chromatography tandem mass spectrometry (LC-MS/MS).

Methods: Separation and detection of busulfan was performed using T3 column equipped with LC-MS/MS. Busulfan was isolated from 50 μL human plasma after mixing with busulfan-2H8 (internal standard) solution, calibrator, and quality-control material. The sample was eluted and gradated with a mobile phase composed of ammonium acetate, formic acid, and water or methanol. The busulfan concentration was quantified using a six-point standard curve. Busulfan and busulfan-2H8 were detected in positive-ion multiple-reaction-monitoring mode. According to the Clinical and Laboratory Standards Institute guideline, we verified the precision, linearity, limit of detection (LOD), limit of quantification (LOQ), and carryover.

Results: Busulfan and busulfan-2H8 were detected at m/z 264.1>151.1 and 272.2>159.1. The total run time was 3 min. Both intra-and inter-assay coefficients of variation were <3%. The calibration curve was linear at 25-5,000 ng/mL. The LOD and LOQ were 2.5 ng/mL and 25 ng/mL, respectively. The recoveries ranged from 92.0-104.8% and the carryover was-0.02%.

Conclusions: Our method for busulfan reduces total run time and has excellent analytical performance. It will be a useful method for therapeutic drug monitoring of busulfan in clinical laboratories.

Keywords: Busulfan; Liquid chromatography-tandem mass spectrometry; Therapeutic drug monitoring.

MeSH terms

  • Busulfan / blood*
  • Chromatography, Liquid / methods*
  • Drug Monitoring*
  • Humans
  • Quality Control
  • Reference Standards
  • Reproducibility of Results
  • Tandem Mass Spectrometry / methods*

Substances

  • Busulfan