Annals of Oncology Advance Access originally published online on June 9, 2006
Annals of Oncology 2006 17(8):1306-1312; doi:10.1093/annonc/mdl128
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© 2006 European Society for Medical Oncology
Low-dose liposomal amphotericin B in the prevention of invasive fungal infections in patients with prolonged neutropenia: results from a randomized, single-center trial
1 Department of Hematology, Oncology, and Transfusion Medicine, 2 Department of Biostatistics and Clinical Epidemiology, Charité-Campus Benjamin Franklin, Berlin, Germany
* Correspondence to: Dr O. Penack, Hematology and Oncology, Campus Benjamin Franklin, Charité, Hindenburgdamm 30, D-12200 Berlin, Germany. Tel: +49-30-8445-2310; Fax: +49-30-8445-2361; E-mail: olaf.penack{at}charite.de
Background: We performed a prospective, randomized, open-label trial to evaluate the efficacy of low-dose liposomal amphotericin B (L-AmB) to reduce the incidence of invasive fungal infections (IFI) in patients with hematological malignancies and prolonged neutropenia (>10 days) following intensive chemotherapy.
Patients and methods: In 219 neutropenic episodes (NE) of 132 patients randomization was performed. Patients received either 50 mg L-AmB every other day (arm A) or no systemic antifungal prophylaxis (arm B).
Results: In the first NE of each patient the incidence of proven or probable IFI (primary end point) was five of 75 patients (6.7%) in arm A and 20 of 57 patients (35%) in arm B (P = 0.001). Invasive aspergillosis occurred less frequently in patients receiving L-AmB-prophylaxis (P = 0.0057), whereas the reduction of invasive candidiasis did not reach statistical significance (P = 0.0655). In all NE the incidence of IFI was five of 110 NE (4.6%) in arm A versus 22 of 109 NE (20.2%) in arm B (P <0.01). Adverse events, possibly related to L-AmB, were observed in five NE (4.6%) and L-AmB was discontinued in three NE (2.8%). No grade 3 or 4 toxicities were observed.
Conclusions: Antifungal prophylaxis with low-dose L-AmB proved to be feasible and effective in our trial.
Key words: prophylaxis, liposomal amphotericin B, fungal infection, neutropenia
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  O. Penack, P. Rempf, B. Graf, I. W. Blau, and E. Thiel Aspergillus galactomannan testing in patients with long-term neutropenia: implications for clinical management Ann. Onc., May 1, 2008; 19(5): 984 - 989. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Robenshtok, A. Gafter-Gvili, E. Goldberg, M. Weinberger, M. Yeshurun, L. Leibovici, and M. Paul Antifungal Prophylaxis in Cancer Patients After Chemotherapy or Hematopoietic Stem-Cell Transplantation: Systematic Review and Meta-Analysis J. Clin. Oncol., December 1, 2007; 25(34): 5471 - 5489. [Abstract] [Full Text] [PDF]
|
|