Comparison of valproate and levetiracetam for the prevention of busulfan-induced seizures in hematopoietic stem cell transplantation

Toshihisa Nakashima, Takashi Tanaka, Keiichi Koido, Yukiko Nishibuchi, Hironobu Hashimoto, Ayumu Ito, Yoshihiro Inamoto, Saiko Kurosawa, Sung Won Kim, Takahiro Fukuda, Hiroyuki Terakado

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

Anticonvulsant administration is the standard of care for prevention of busulfan-induced seizures (BIS) in hematopoietic stem cell transplantation (HSCT). While valproate interacts with other drugs, including carbapenem antibiotics, levetiracetam has no known clinically significant interactions. Only a few reports have discussed the use of levetiracetam for the prevention of BIS in HSCT recipients. This retrospective study aimed to evaluate the efficacy and safety of valproate and levetiracetam for BIS prophylaxis in adult HSCT recipients. We identified patients who received valproate or levetiracetam to prevent BIS at the National Cancer Center Hospital from December 2015 to November 2017. Ninety-one patients were analyzed (valproate group 45; levetiracetam group 46). No BIS occurred in either group. The pattern of anticonvulsant-related adverse events was similar in both groups, except for a higher incidence of rash in the valproate group. Carbapenem antibiotics were more frequently used in the levetiracetam group than in the valproate group. In conclusion, valproate and levetiracetam are effective and safe for the prophylaxis of BIS. Levetiracetam may be more useful in patients colonized with extended-spectrum beta-lactamase-producing bacteria due to its lack of any clinically significant drug–drug interactions.

Original languageEnglish
Pages (from-to)694-699
Number of pages6
JournalInternational Journal of Hematology
Volume109
Issue number6
DOIs
Publication statusPublished - 20-06-2019
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hematology

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