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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
5-6
|
| pubmed:dateCreated |
1997-7-8
|
| pubmed:abstractText |
Suspected deep or systemic mycosis in patients undergoing high-dose therapy and autologous or allogeneic bone marrow transplantation (BMT) requires an immediate systemic antimycotic therapy. Intravenous therapy with the standard drug conventional amphotericin-B is associated with severe adverse effects like nephrotoxicity and chills. Furthermore, BMT patients often receive other potential nephrotoxic drugs such as CsA or virustatics. In this study, we report 74 BMT-patients treated with liposomal amphotericin-B for culture-documented aspergillosis (n = 5) or candidiasis (n = 6), or for serologically (n = 35) or clinically suspected mycosis or as prophylaxis (n = 2). Therapy was initiated with a median dose of 2.8 (0.64-5.09) mg/kg body-weight and continued for 13 (1-55) days. The drug was excellently tolerated and only in one was therapy stopped due to severe chills and fever. Severe organ impairment was not observed under therapy with liposomal amphotericin-B. Creatinine decreased in five patients after an increase under preceding therapy with the conventional formulation. Influence of liposomal amphotericin-B on bilirubin and transaminases was difficult to evaluate due to therapy-related toxicity, veno-occlusive disease (VOD), and graft-versus-host disease (GvHD). 10/11 culture-positive patients died from aspergillosis (5/5) or candidiasis (5/6), but in 9/11 of these subjects the immunity was additionally compromised by GvHD, steroid therapy, and VOD. Liposomal amphotericin-B was effective in preventing relapse of systemic mycosis in 10/12 patients with a history of aspergillosis (n = 11) or candidiasis (n = 1). We conclude, that favourable toxicity of liposomal amphotericin-B should encourage dose escalation studies of liposomal amphotericin-B randomised against the conventional formulation and that the comparison of patients undergoing BMT with patients under standard chemotherapy might be difficult because of additional risk factors of the BMT-patients.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
IM
|
| pubmed:chemical |
http://linkedlifedata.com/resource/pubmed/chemical/Amphotericin B,
http://linkedlifedata.com/resource/pubmed/chemical/Antifungal Agents,
http://linkedlifedata.com/resource/pubmed/chemical/Antineoplastic Agents,
http://linkedlifedata.com/resource/pubmed/chemical/Drug Carriers,
http://linkedlifedata.com/resource/pubmed/chemical/Liposomes
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
Feb
|
| pubmed:issn |
1042-8194
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:volume |
24
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
491-9
|
| pubmed:dateRevised |
2009-11-19
|
| pubmed:meshHeading |
pubmed-meshheading:9086439-Adolescent,
pubmed-meshheading:9086439-Adult,
pubmed-meshheading:9086439-Amphotericin B,
pubmed-meshheading:9086439-Antifungal Agents,
pubmed-meshheading:9086439-Antineoplastic Agents,
pubmed-meshheading:9086439-Bone Marrow Transplantation,
pubmed-meshheading:9086439-Child,
pubmed-meshheading:9086439-Child, Preschool,
pubmed-meshheading:9086439-Dose-Response Relationship, Drug,
pubmed-meshheading:9086439-Drug Carriers,
pubmed-meshheading:9086439-Female,
pubmed-meshheading:9086439-Hematopoietic Stem Cell Transplantation,
pubmed-meshheading:9086439-Humans,
pubmed-meshheading:9086439-Infant,
pubmed-meshheading:9086439-Liposomes,
pubmed-meshheading:9086439-Male,
pubmed-meshheading:9086439-Middle Aged,
pubmed-meshheading:9086439-Mycoses
|
| pubmed:year |
1997
|
| pubmed:articleTitle |
Antimycotic therapy with liposomal amphotericin-B for patients undergoing bone marrow or peripheral blood stem cell transplantation.
|
| pubmed:affiliation |
Department of Oncology/Haematology, University-Hospital Eppendorf, Hamburg, Germany.
|
| pubmed:publicationType |
Journal Article,
Clinical Trial
|