RT Journal Article
SR Electronic
T1 Efficacy and Safety of Low-Dose Liposomal Amphotericin B in Adult Patients Undergoing Unrelated Cord Blood Transplantation
JF Antimicrobial Agents and Chemotherapy
JO Antimicrob. Agents Chemother.
FD American Society for Microbiology
SP e01205-18
DO 10.1128/AAC.01205-18
VO 62
IS 11
A1 Yasu, Takeo
A1 Konuma, Takaaki
A1 Oiwa-Monna, Maki
A1 Kato, Seiko
A1 Tanoue, Susumu
A1 Isobe, Masamichi
A1 Mizusawa, Mai
A1 Kuroda, Seiichiro
A1 Takahashi, Satoshi
A1 Tojo, Arinobu
YR 2018
UL http://aac.asm.org/content/62/11/e01205-18.abstract
AB Liposomal amphotericin B (L-AMB) is widely used for empirical or preemptive therapy and treatment of invasive fungal infections after cord blood transplantation (CBT). We retrospectively examined the efficacy and safety of low-dose L-AMB in 48 adult patients who underwent CBT between 2006 and 2017 in our institute. Within the entire cohort, 42 patients (88%) received L-AMB as empirical or preemptive therapy. The median daily dose of L-AMB and the median cumulative dose of L-AMB were 1.20 mg/kg/day (range, 0.62 to 2.60 mg/kg/day) and 30.6 mg/kg (range, 0.7 to 241.5 mg/kg), respectively. The median duration of L-AMB administration was 21.5 days (range, 1 to 313 days). A documented breakthrough fungal infection occurred in 1 patient during L-AMB treatment, and 43 patients (90%) survived for at least 7 days after the end of L-AMB treatment. Grade 3 or higher hypokalemia and hepatotoxicity were frequently observed during L-AMB treatment. However, no patient developed an increase in serum creatinine levels of grade 3 or higher. In univariate analyses using a logistic regression model, a duration of L-AMB treatment of more than 21 days and a cumulative dose of L-AMB of more than 30 mg/kg were significantly associated with nephrotoxicity and grade 3 hypokalemia. These data suggest that low-dose L-AMB may be safe and effective in adult patients undergoing CBT.