Transfusing platelets 2 h after the completion of amphotericin-B decreases its detrimental effect on transfused platelet recovery and survival.
Platelet transfusion support is required during bone marrow aplasia following ablative chemotherapy and bone marrow progenitor cell transplantation (BMT). Amphotericin-B is frequently given to these patients, both therapeutically and prophylactically, and has been described to have a negative impact on the results of platelet transfusions. We conducted a prospective study of the effect of amphotericin-B on transfused platelet recovery and survival in 81 BMT or acute leukaemia patients. One hundred and ninety-five platelet transfusions administered to 81 consecutive patients were analysed. The platelets were transfused 2 h after the completion of amphotericin-B. Using this schedule resulted in no effect of amphotericin-B on platelet recovery or survival, although platelet increments were modestly depressed in patients receiving high- vs. low-dose amphotericin-B. We conclude that the timing of amphotericin-B infusion be evaluated in patients demonstrating poor platelet recovery and survival. Transfusing platelets at least 2 h after the completion of amphotericin-B decreases the detrimental effect of this antifungal agent on transfused platelet recovery and survival.
Hussein
M A
MA
Cleveland Clinic Cancer Center, Cleveland Clinic Foundation, USA husseim@cesmtp.ccf.org
Fletcher
R
R
Long
T J
TJ
Zuccaro
K
K
Bolwell
B J
BJ
Hoeltge
A
A
D000666:Amphotericin B / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000494:pharmacology; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000494:pharmacology; D001792:Blood Platelets / Q000187:drug effects*; D016026:Bone Marrow Transplantation; D002470:Cell Survival / Q000187:drug effects; D004334:Drug Administration Schedule; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D016867:Immunocompromised Host; D009181:Mycoses / Q000517:prevention & control; D009369:Neoplasms / Q000097:blood / Q000188:drug therapy / Q000628:therapy; D010976:Platelet Count / Q000187:drug effects*; D017713:Platelet Transfusion / Q000379:methods*; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000209:etiology / Q000628:therapy; D013997:Time Factors
D000935:Antifungal Agents; D000666:Amphotericin B