| Autor: |
Wu YB; Department of Hematology, The Hospital of Suzhou Hongci Hematology, Suzhou 215000, China., Jiang SS; Department of Hematology, The Hospital of Suzhou Hongci Hematology, Suzhou 215000, China., Wu YX; Department of Hematology, The Hospital of Suzhou Hongci Hematology, Suzhou 215000, China., Liu B; Department of Hematology, The Hospital of Suzhou Hongci Hematology, Suzhou 215000, China., Jing YT; Department of Hematology, The Hospital of Suzhou Hongci Hematology, Suzhou 215000, China., Bao HY; Department of Hematology, The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China., Ma X; Department of Hematology, The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China., Wu DP; Department of Hematology, The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China., Hu XH; Department of Hematology, The Hospital of Suzhou Hongci Hematology, Suzhou 215000, China Department of Hematology, The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, Suzhou 215000, China. |
| Abstrakt: |
Objective: To investigate the efficacy and safety of liposomal amphotericin B (L-AmB) for the salvage treatment of invasive fungal disease (IFD) in patients with hematological diseases. Methods: Data were retrospectively collected from 80 patients with hematological issues treated with L-AmB between June 2023 and December 2023 after failure of previous antifungal therapy. Baseline patient information, clinical efficacy, and factors affecting the efficacy of L-AmB were analyzed by logistic regression. Moreover, adverse effects associated with L-AmB were evaluated. Results: Among the 80 patients, 9 (11.2%) had proven IFD, 43 (53.8%) had probable IFD, and 28 (35.0%) had possible IFD. The efficacy rate of L-AmB salvage therapy for IFD was 77.5%, with a median daily dose of 3 (range: 1-5) mg·kg(-1)·d(-1) and a median dosing course of 14 (range: 8-25) days. Multivariate logistic regression analysis showed that the disease remission status ( OR =4.337, 95% CI 1.167-16.122, P =0.029) and duration of medication ( OR =1.127, 95% CI 1.029-1.234, P =0.010) were independent factors affecting the efficacy of L-AmB. The incidence of infusion reactions associated with L-AmB, including fever and chills, was 5.0%. The incidence of hypokalemia was 28.8% (predominantly grades 1-2), and the incidence of nephrotoxicity was 11.3% (predominantly grades 1-2) . Conclusion: L-AmB is safe and effective in the treatment of patients with IFD who are intolerant to or who have experienced no effect of previous antifungal therapy, with a low rate of adverse reactions. |
