Leenders, Alexander C. A. P.;
Daenen, Simon;
Jansen, Rob L. H.;
Hop, Wim C. J.;
Lowenberg, Bob;
Wijermans, Pierre W.;
Cornelissen, Jan;
Herbrecht, Raoul;
Lelie, Hans Van Der;
Hoogsteden, Henk C.;
Verbrugh, Henri A.;
Marie, Siem De
Liposomal amphotericin B compared with amphotericin B deoxycholate in the treatment of documented and suspected neutropenia‐associated invasive fungal infections
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Medientyp:
E-Artikel
Titel:
Liposomal amphotericin B compared with amphotericin B deoxycholate in the treatment of documented and suspected neutropenia‐associated invasive fungal infections
Beteiligte:
Leenders, Alexander C. A. P.;
Daenen, Simon;
Jansen, Rob L. H.;
Hop, Wim C. J.;
Lowenberg, Bob;
Wijermans, Pierre W.;
Cornelissen, Jan;
Herbrecht, Raoul;
Lelie, Hans Van Der;
Hoogsteden, Henk C.;
Verbrugh, Henri A.;
Marie, Siem De
Erschienen:
Wiley, 1998
Erschienen in:
British Journal of Haematology, 103 (1998) 1, Seite 205-212
Sprache:
Englisch
DOI:
10.1046/j.1365-2141.1998.00944.x
ISSN:
0007-1048;
1365-2141
Entstehung:
Anmerkungen:
Beschreibung:
It has been suggested that a better outcome of neutropenia‐associated invasive fungal infections can be achieved when high doses of lipid formulations of amphotericin B are used. We now report a randomized multicentre study comparing liposomal amphotericin B (AmBisome, 5 mg/kg/d) to amphotericin B deoxycholate (AmB, 1 mg/kg/d) in the treatment of these infections. Of 106 possible patients, 66 were enrolled and analysed for efficacy: nine had documented fungaemia, 17 had other invasive mould infections and 40 had suspected pulmonary aspergillosis. After completion of the course medication, in the AmBisome group (n = 32) 14 patients had achieved complete response, seven a partial response and 11 were failures as compared to 6, 13 and 15 patients (n = 34) treated with AmB (P = 0.09); P = 0.03 for complete responders. A favourable trend for AmBisome was found at day 14, in patients with documented infections and in patients with pulmonary aspergillosis (P = 0.05 and P = 0.096 respectively). Mortality rates were lower in patients treated with AmBisome (adjusted for malignancy status, P = 0.03). More patients on AmB had a >100% increase of their baseline serum creatinine (P < 0.001).The results indicate that, in neutropenic patients with documented or suspected invasive fungal infections AmBisome 5 mg/kg/d was superior to AmB 1 mg/kg/d with respect to efficacy and safety.