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Experience with liposomal Amphotericin‐B in 60 patients undergoing high‐dose therapy and bone marrow or peripheral blood stem cell transplantation
Author(s) -
Krüger William,
Stockschläder Marcus,
Rüssmann Bettina,
Berger Carolina,
Hoffknecht Matthias,
Sobottka Ingo,
Kohlschütter Brigitte,
Kroschke Gerd,
Kröger Nicolaus,
Horstmann Martin,
Kabisch Hartmut,
Zander Axel R.
Publication year - 1995
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1995.tb05369.x
Subject(s) - amphotericin b , medicine , adverse effect , mycosis , transplantation , surgery , creatinine , chemotherapy , bone marrow , gastroenterology , aspergillosis , immunology , antifungal , dermatology
Summary. 60 patients undergoing bone marrow or stem cell transplantation were treated with liposomal Amphotericin‐B for documented or suspected mycosis. 34 patients had a prior course of conventional Amphotericin‐B with the following adverse effects: increasing creatinine above l‐4mg/dl ( n =17), increasing creatinine below l‐5mg/dl ( n = 9), no response ( n = 6), and clinical side‐effects ( n = 4). Liposomal Amphotericin‐B failed in 6/7 patients with culture‐proven mycosis who died from infection with Aspergillus (n = 2) and Candida (n = 4), respectively. One patient with Candida lambica sepsis was cured. No patient with clinically or serologically suspected or diagnosed infection died from mycosis. Liposomal Amphotericin‐B was well tolerated in 57 patients, even after side‐effects of the conventional formulation. Adverse effects occurred in three cases, requiring the withdrawal of the drug in one patient. Due to toxic side‐effects of the high‐dose therapy and transplant‐related complications, it was difficult to evaluate the influence of liposomal Amphotericin‐B on laboratory parameters. Eight patients showed a decrease of creatinine levels, which had increased above normal values under preceding therapy with conventional Amphotericin‐B. Liposomal Amphotericin‐B is well tolerated in patients undergoing high‐dose therapy and bone marrow transplantation. The efficacy of liposomal Amphotericin‐B needs to be investigated in randomized studies in comparison with conventional Amphotericin‐B.