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July 24, 1967

Busulfan Treatment During Pregnancy

Author Affiliations

Porto, Portugal

JAMA. 1967;201(4):272. doi:10.1001/jama.1967.03130040068024

To the Editor:—  In "Busulfan Treatment of Leukemia During Pregnancy" (199:131, 1967), Dugdale and Fort conclude, "Busulfan when used alone and in the usual dosage is not toxic to the human fetus." This conclusion is based upon two facts: (1) In all instances (ten cases) in which busulfan was the sole antileukemic agent used during pregnancy, the infants were apparently normal (although three were small). (2) The single dose that, administered to the rat, produces sterility in both male and female offspring1 is considerably higher than the daily doses used clinically; even the total dose is less in most patients. The authors noted, without comments, the report of Diamond, et al2 concerning an infant with ovarian aplasia whose mother took mercaptopurine and busulfan during pregnancy. It is possible that the conclusion of Dugdale and Fort is right, but I think that their arguments are questionable.We cannot