title: Prophylactic application of nebulized liposomal amphotericin B in hematologic patients with neutropenia.
abstract: BACKGROUND
  Pulmonary invasive fungal infections (IFI) are well-recognized complications with high morbidity and mortality in patients with hematologic malignancies.
  
  
  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.
authors.affiliation: Abteilung für Hämatologie und Internistische Onkologie, Klinikum der Universität Regensburg, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Hullard-Pulstinger
authors.forename: Ernst
authors.initials: E
authors.lastname: Holler
authors.forename: Joachim
authors.initials: J
authors.lastname: Hahn
authors.forename: Reinhard
authors.initials: R
authors.lastname: Andreesen
authors.forename: Stefan W
authors.initials: SW
authors.lastname: Krause
mesh_terms: D000666:Amphotericin B / Q000008:administration & dosage*; D000935:Antifungal Agents / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008172:Lung Diseases, Fungal / Q000209:etiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications* / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; C068538:liposomal amphotericin B; D000666:Amphotericin B