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Pharmacodynamics of High-Dose Chemotherapy

[ Vol. 2 , Issue. 1 ]


Yago Netio   Pages 53 - 66 ( 14 )


There is usually considerable variability in anticancer drug plasma levels when delivered at high doses requiring stem-cell support. Given their narrow therapeutic windows and wide interpatient pharmacokinetic variability, drug monitoring and pharmacokinetic-directed dosing represent an attractive strategy in this setting. A major previous requirement to successful application of therapeutic drug monitoring is identification of a significant and clinically meaningful pharmacodynamic correlation between a pharmacokinetic parameter and a toxic or therapeutic outcome, or preferably, both. In this review, we will analyze the current knowledge of identified pharmacodynamic correlations in high-dose chemotherapy. We will summarize the observations from other authors and our own, on drugs employed at high doses, such as cyclophosphamide, melphalan, busulfan, carmustine, paclitaxel, or docetaxel.


Pharmacodynamics High-Dose Chemotherapy, anticancer drug plasma levels, cyclophosphamide, melphalan, busulfan, carmustine, paclitaxel, docetaxel


University of Colorado Bone Marrow Transplant Program, 4200 East ninth Avenue, B¾, Denver, Colorado 80262, USA.

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