Continuously infused amphotericin B deoxycholate for primary treatment of invasive fungal disease in acute myeloid leukaemia

Abstract Continuous administration of amphotericin B deoxycholate over 24 hours (24 h‐D‐AmB) is better tolerated than rapid infusions. However, toxicity and outcome have not been assessed in a homogenous patient population with acute myeloid leukaemia (AML). We retrospectively analysed renal function and outcome in all adult patients with AML undergoing intensive chemotherapy between 2007 and 2012 at our institution. We compared a patient group with exposure to 24 h‐D‐AmB to a patient group without exposure to 24 h‐D‐AmB. One hundred and eighty‐one consecutive patients were analysed, 133 (73.5%) received at least 1 dose of 24 h‐D‐AmB, and 48 (26.5%) did not. Reasons for 24 h‐D‐AmB initiation were invasive fungal disease (IFD) in 63.5% and empirical treatment for febrile neutropenia in 36.5% of the cases. Most patients with IFD received an oral triazole drug at hospital discharge. Baseline characteristics were well matched. Amphotericin B deoxycholate over 24 hours was given for a median 7 days (interquartile range 3‐13). Peak creatinine concentration was higher in the 24 h‐D‐AmB‐group (104.5 vs. 76 μmol/L, P < .001) but normalized within 1 month after therapy (65.5 vs. 65 μmol/L, P = .979). In neither of the 2 groups, end‐stage renal disease occurred. There was no difference in 60‐day survival (90% vs. 90%) and 2‐year survival (58% vs. 58%). Invasive fungal disease partial response or better was observed in 68% of the p...
Source: Hematological Oncology - Category: Hematology Authors: Tags: ORIGINAL RESEARCH ARTICLE Source Type: research