EXPERIENCE WITH LIPOSOMAL AMPHOTERICIN-B IN 60 PATIENTS UNDERGOING HIGH-DOSE THERAPY AND BONE-MARROW OR PERIPHERAL-BLOOD STEM-CELL TRANSPLANTATION

被引:19
作者
KRUGER, W [1 ]
STOCKSCHLADER, M [1 ]
RUSSMANN, B [1 ]
BERGER, C [1 ]
HOFFKNECHT, M [1 ]
SOBOTTKA, I [1 ]
KOHLSCHUTTER, B [1 ]
KROSCHKE, G [1 ]
KROGER, N [1 ]
HORSTMANN, M [1 ]
KABISCH, H [1 ]
ZANDER, AR [1 ]
机构
[1] UNIV HAMBURG,HOSP EPPENDORF,INST MED MICROBIOL & IMMUNOL,D-20246 HAMBURG,GERMANY
关键词
BMT; NEUTROPENIA; LIPOSOMAL AMPHOTERICIN-B; INVASIVE MYCOSIS; FUNGAL SEPSIS;
D O I
10.1111/j.1365-2141.1995.tb05369.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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 1.4 mg/dl (n=17), increasing creatinine below 1.5 mg/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 fi om infection with Aspergillus (n=2) and Canadida (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.
引用
收藏
页码:684 / 690
页数:7
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