Treatment of mycotic infections after haemopoietic progenitor cell transplantation with liposomal amphotericin-B.
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| Abstract |
115 patients undergoing allogeneic or autologous bone marrow or peripheral blood stem cell transplantation were treated empirically or for documented fungal infection with liposomal amphotericin-B in doses up to 10mg/kg bodyweight for a duration up to 61 days. The therapy was excellent tolerated and clinical side effects occurred in only eight patients. The drug had to be withdrawn in one episode. A significant influence of liposomal amphotericin-B on laboratory parameters was not observed. Creatinine increased under therapy from a median base point of 1,0 (0,2-3,5) mg/dl to the upper normal value of 1,4 (0,4-4,2) mg/dl. Heavy increases of creatinine as well as of bilirubin, OT and PT were mostly associated with GvHD or regimen related toxicity. Considering the high-risk state of the patients the overall response rate was favourable with 62,9%. However, despite administration of liposomal amphotericin-B culture-proven mycoses were associated with a high morbidity (93,3%). Only one of fourteen patients was cured from Candida lambica septicaemia. We conclude that the antimycotic therapy with liposomal amphotericin-B has a low incidence of side effects. This should, considering the high mortality of fungal infections in BMT recipients, encourage investigators to perform dose escalating studies against the conventional formulation.
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| Authors | W H Krüger, N Kröger, B Rüssmann, H Renges, H Kabisch, A R Zander |
| Journal | Bone marrow transplantation (Bone Marrow Transplant) Vol. 22 Suppl 4 Pg. S10-3 (Dec 1998) ISSN: 0268-3369 [Print] England |
| PMID | 9916623 (Publication Type: Clinical Trial, Journal Article) |
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