Introduction: Patients (pts) with acute leukemia (AL) or undergoing hematopoetic stem cell transplantation (HSCT) carry a high risk for invasive fungal infections (IFI). Amphoterician B lipid complex (ABLC) is effective when used empirically or preemptively for IFI in such pts.
Materials (or patients) and methods: In this retrospective study, we aim to evaluate the use of ABLC on an empiric or preemptive basis for the management of IFI in pts with AL or undergoing HSCT. We mainly focused on response rate and tolerability along with the adverse drug events associated with ABLC therapy; in addition to premedication combinations used in the prevention of drug delivery reactions (DDR).
Results: In this retrospective study reviewing 3 years’ experience (between January 2011 and January 2014), a total of 78 pts received ABLC therapy for suspected IFI. Sixty-five percent were treated preemptively and 25% were treated empirically.The overall response rate was 56%.Nephrotoxicity occurred in 24%of pts and improved of serum creatinine was in 5.3%. Moderate hypokalemia was present in 60.8% of the pts and severe hypokalemia was present in 10% but was almost correctable. Eleven percent showed hepatotoxicity throughout ABLC therapy. Drug delivery reactions were observed in 27.8% of the pts. There was a tendency to decrease the incidence of infusion reactions upon using a combination of premedication drugs including paracetamol, steroids, pethidine and antihistamines. Overall mortality rate was »20%.
Conclusion: This study suggests that ABLC used emptively or preemptively is an effective and safe treatment option of suspected IFI in pts with AL or undergoing HSCT.
Full conference title:
- EBMT 41st (2015)