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Once-weekly liposomal amphotericin B for prophylaxis of invasive fungal infection after graft-versus-host disease in allogeneic hematopoietic stem cell transplantation: a comparative retrospective single-center study

Jean El Cheikh, Luca Castagna, Ling Wang, Benjamin Esterni, Catherine Faucher, Sabine Furst, Segolene Duran, Pierre Berger, Stephane Ranque, Mohamad Mohty, Didier Blaise
2010 Hematology/Oncology and Stem Cell Therapy  

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BACKGROUND AND OBJECTIVES: the liposomal formulation of amphotericin b (lamb) has been shown to cause few and mild infusion-related reactions, while achieving high plasma and tissue concentrations compared with conventional amphotericin b. We investigated the efficacy and safety of high-dose lamb (7.5 mg/kg once weekly) prophylaxis of fungal infections in allogeneic stem-cell transplanted (allo-sct) patients with graft-ver-sus-host disease (Gvhd). DESIGN AND SETTING: retrospective, comparative,
more » ... single-center. METHODS: forty-two patients receiving high-dose prednisone for Gvhd after allo-sct had lamb prophylaxis; 83 patients in the control group received other antifungal prophylaxis. RESULTS: in the lamb prophylaxis group, the median duration of treatment was 7 weeks. the cumulative inci-dence of invasive fungal infection was 8% at 1 year after transplantation, 8% at 2 years and 16% at 3 years in the lamb group vs. 36% at 1 year, 44% at 2 years and 49% at 3 years in the other prophylaxis group (P=.008). fungal infection-related mortality after transplantation was observed in none of the patients in the lamb prophy-laxis group vs. 12 patients (14%) at 1 year, 14 patients (17%) at 2 years and 16 patients (19%) at 3 years in the control group (P=.005). the tolerance of the treatment was good with only 5 patients (12%) having a reversible nephrotoxicity leading to temporary treatment discontinuation. CONCLUSIONS: high-dose lamb prophylaxis seems effective and well tolerated in this short series of allo-sct patients with Gvhd. prospective clinical studies are required to confirm these results.
doi:10.5144/1658-3876.2010.167 fatcat:6qxgl4fimfhthi5d7pofo62lx4
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Jean El Cheikh, Luca Castagna, Ling Wang, Benjamin Esterni, Catherine Faucher, Sabine Furst, Segolene Duran, Pierre Berger, Stephane Ranque, Mohamad Mohty, Didier Blaise. "Once-weekly liposomal amphotericin B for prophylaxis of invasive fungal infection after graft-versus-host disease in allogeneic hematopoietic stem cell transplantation: a comparative retrospective single-center study." Hematology/Oncology and Stem Cell Therapy 3.4 (2010) 167-173