Experience with liposomal Amphotericin-B in 60 patients undergoing high-dose therapy and bone marrow or peripheral blood stem cell transplantation
Autor: | Brigitte Kohlschütter, Matthias Hoffknecht, William Krüger, Nicolaus Kröger, Hartmut Kabisch, B Rüssmann, Martin A. Horstmann, Axel R. Zander, Marcus Stockschläder, Ingo Sobottka, Carolina Berger, Gerd Kroschke |
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Rok vydání: | 1995 |
Předmět: |
Adult
Male medicine.medical_specialty Antifungal Agents Neutropenia Adolescent medicine.medical_treatment Opportunistic Infections Gastroenterology Sepsis Amphotericin B Internal medicine medicine Aspergillosis Humans Child Adverse effect Mycosis Bone Marrow Transplantation Chemotherapy Leukopenia Lung Diseases Fungal business.industry Hematopoietic Stem Cell Transplantation Infant Hematology Middle Aged medicine.disease Surgery Transplantation Treatment Outcome medicine.anatomical_structure Mycoses Child Preschool Female Bone marrow medicine.symptom business |
Zdroj: | British Journal of Haematology. 91:684-690 |
ISSN: | 1365-2141 0007-1048 |
Popis: | 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 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. |
Databáze: | OpenAIRE |
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