Efficacy and toxicity of intermediate-dose amphotericin B lipid complex as a primary or salvage treatment of fungal infections in patients with hematological malignancies

Rodrigo Martino, Montserrat Cortés, Maricel Subirá, Rocio Parody, Estela Moreno, Jorge Sierra

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15 Citations (Scopus)

Abstract

We treated 74 adults with a hematological malignancy and documented or suspected invasive fungal infection (IFI) with amphotericin B lipid complex (ABLC) at 3 mg/kg/day. Forty-five patients (61%) received upfront therapy and 29 patients (39%) received salvage therapy for their IFI. Forty-eight of 71 evaluable patients responded [complete responses in 40 (56%) and partial responses in 8 (11%)] and 15 (21%) died as a consequence of the IFI. Response rates in invasive aspergillosis were 33 out of 49 (67%) for probable/definite cases and 6 out of 11 (55%) for invasive candidiasis. In 40 patients with neutropenia-associated IFI, rapid neutropenic recovery (< 10 days from study entry) was essential for response to therapy (90% vs. 32%, P < 0.01). Treatment was well tolerated, with 15% infusions followed by infusion-related adverse events, nephrotoxicity in 7% of patients and 11% of withdrawals due to toxicity. These data suggest that intermediate-doses of ABLC may be of similar efficacy than higher doses with less toxicity, making it a cost-effective alternative worthy of study in future trials. © 2005 Taylor & Francis.
Original languageEnglish
Pages (from-to)1429-1435
JournalLeukemia and Lymphoma
Volume46
Issue number10
DOIs
Publication statusPublished - 1 Oct 2005

Keywords

  • Abelcet
  • Amphotericin B
  • Fungal infections
  • Hematological malignancies

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