Amphotericin B lipid complex for the treatment of patients with acute leukemia and hepatosplenic candidiasis.
Hepatosplenic candidiasis (HSC) is an emerging complication of the treatment of patients with acute leukemia. Treatment of this infection can be very difficult and data on the duration of antifungal therapy are not available. We evaluated the efficacy of amphotericin B lipid complex (ABLC) for the treatment of five patients with acute leukemia and HSC. The dose of the administered ABLC ranged between 5 and 11 mg/kg per day and the median duration of therapy was 4.3 months. Four patients had complete response to the above treatment with resolution of fever and improvement in the radiologic findings. One patient refused to continue treatment and subsequently died with relapsed leukemia and disseminated Candida infection. Preliminary data suggest that ABLC is a well-tolerated and effective treatment for HSC and should be considered for phase II trials as front line treatment for this type of deep seated fungal infections.
Sallah
S
S
Department of Medicine, University of Tennessee, Memphis 38163, USA.
Semelka
R C
RC
Sallah
W
W
Vainright
J R
JR
Philips
D L
DL
D000208:Acute Disease; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects; D002177:Candidiasis / Q000139:chemically induced / Q000188:drug therapy*; D056486:Chemical and Drug Induced Liver Injury; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007951:Leukemia, Myeloid / Q000150:complications* / Q000188:drug therapy; D008107:Liver Diseases / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010713:Phosphatidylcholines / Q000627:therapeutic use*; D010715:Phosphatidylglycerols / Q000627:therapeutic use*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy; D013158:Splenic Diseases / Q000139:chemically induced / Q000188:drug therapy*
D000935:Antifungal Agents; D000970:Antineoplastic Agents; D004338:Drug Combinations; D010713:Phosphatidylcholines; D010715:Phosphatidylglycerols; C068538:liposomal amphotericin B; D000666:Amphotericin B