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Onkologie. 2011;34(5):254-8. doi: 10.1159/000327802. Epub 2011 Apr 26.

Prophylactic application of nebulized liposomal amphotericin B in hematologic patients with neutropenia.

Author information

1
Abteilung für Hämatologie und Internistische Onkologie, Klinikum der Universität Regensburg, Germany.

Abstract

BACKGROUND:

Pulmonary invasive fungal infections (IFI) are well-recognized complications with high morbidity and mortality in patients with hematologic malignancies.

PATIENTS AND METHODS:

Aerosolized liposomal amphotericin B (lipAmB) was evaluated as an antifungal prophylaxis in patients with an expected neutropenia of more than 10 days due to intensive chemotherapy or stem cell transplantation, in a prospective phase II trial.

RESULTS:

98 treatment episodes were included in the study and compared to 105 historical control patients. Inhalation was performed between 0 and 103 days. No severe side effects of therapy occurred. 40 patients considered inhalations as unpleasant, 2 as very unpleasant, mostly due to bad taste or cough. Few cases of definite or probable IFI were recorded, whereas a large number of patients were treated with systemic antifungal therapy for pneumonia or fever of unknown origin without a significant difference between study patients and controls. In a predefined subgroup analysis of 48 patients with newly diagnosed acute myeloid leukemia (AML), significantly more patients survived for 1 year in the AmB prophylaxis than in the control group (80% vs. 54%, p < 0.01).

CONCLUSIONS:

Inhalations of lipAmB are feasible and safe. Results in the subgroup of patients with AML together with data from other trials suggest further evaluation of effectiveness.

PMID:
21577031
DOI:
10.1159/000327802
[Indexed for MEDLINE]

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