Search

Background: Busulfan is widely used in conditioning regimens to prepare patients for hematopoietic stem cell transplantation. Therapeutic drug monitoring (TDM) is critical due to large inter- and intra-individual variability in busulfan pharmacokinetics, and the risk of adverse consequences of toxicity including hepatic veno-occlusive disease. Busulfan is most commonly measured by liquid chromatography–mass spectrometry (LC-MS/MS), which is not as widely available in clinical laboratories as automated routine clinical chemistry analyzers. The objective was to perform analytical verification of a busulfan immunoassay on the Abbott Alinity c platform. Methods: The MyCare Oncology busulfan immunoassay was configured as a third-party reagent on the Abbott Alinity c. Imprecision, linearity, sample carryover, and onboard stability of reagent studies were evaluated. The performance of the busulfan immunoassay using the Abbott Alinity c was compared to the Beckman Coulter AU480 using sodium heparinized plasma, as well as to LC-MS/MS using lithium heparinized plasma. Results: The imprecision goal of 8% was met, and linearity within the analytical measurement range of 240 to 1700 ng/mL was verified. Sample carryover was negligible, and the reagents were stable onboard for at least 84 days. The busulfan immunoassay correlated well with LC-MS/MS (slope = 0.949, y-intercept = −7.8 ng/mL, r2 = 0.9935) and the Beckman Coulter AU480 (slope = 1.090, y-intercept = −34.5 ng/mL, r2 = 0.9988). Conclusions: This study demonstrated successful analytical verification of a busulfan third-party immunoassay on the Abbott Alinity c platform. The ability to perform TDM of busulfan on a routine clinical chemistry analyzer will positively impact turnaround times to improve patient outcomes. [ABSTRACT FROM AUTHOR]

This paper investigates the ethics of regarding others as epistemically hopeless. To regard a person as epistemically hopeless with respect to p is, roughly, to regard her as unable to see the truth of p through rational means. Regarding a person as epistemically hopeless is a stance that has surprising and nuanced moral implications. It can be a sign of respect, and it can also be a way of giving up on someone. Whether it is morally problematic to take up this stance, I argue, depends on the choices that one faces (or is likely to face). I close the paper by arguing against the view that there are standing moral reasons against regarding others as epistemically hopeless. [ABSTRACT FROM AUTHOR]