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.

中文翻译：

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丙戊酸和左乙拉西坦在造血干细胞移植中预防白硫丹引起的癫痫发作的比较。

抗抽搐药物的给药是预防造血干细胞移植（HSCT）中由白硫丹引起的癫痫发作（BIS）的护理标准。丙戊酸盐与其他药物（包括碳青霉烯抗生素）相互作用时，左乙拉西坦尚无临床上显着的相互作用。只有少数报告讨论了左乙拉西坦在HSCT接受者中预防BIS的用途。这项回顾性研究旨在评估丙戊酸和左乙拉西坦在成人HSCT接受者中预防BIS的有效性和安全性。我们于2015年12月至2017年11月在美国国家癌症中心医院确定了接受丙戊酸或左乙拉西坦预防BIS的患者。分析了91名患者（丙戊酸第45组；左乙拉西坦组46）。两组均未发生BIS。除丙戊酸盐组皮疹发生率较高外，两组中与惊厥相关的不良事件的发生方式相似。左乙拉西坦组比丙戊酸盐组更经常使用碳青霉烯类抗生素。总之，丙戊酸和左乙拉西坦是预防BIS的有效方法和安全方法。左乙拉西坦由于缺乏任何临床上重要的药物-药物相互作用，因此在定植广谱β-内酰胺酶细菌中的患者可能更有用。