Clinical efficacy and safety of liposomal amphotericin B in the salvage treatment of invasive fungal disease in patients with hematological diseases
10.3760/cma.j.cn121090-20240228-00075
- VernacularTitle:两性霉素B脂质体挽救性治疗80例血液病患者侵袭性真菌病临床疗效分析
- Author:
Yuanbing WU
1
;
Shanshan JIANG
;
Yaxue WU
;
Bin LIU
;
Yutong JING
;
Haiyan BAO
;
Xiao MA
;
Depei WU
;
Xiaohui HU
Author Information
1. 苏州弘慈血液病医院血液科，苏州 215000
- Keywords:
Liposomal amphotericin B;
Hematological diseases;
Invasive fungal disease
- From:
Chinese Journal of Hematology
2024;45(7):666-671
- CountryChina
- Language:Chinese
-
Abstract:
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.
