title: Hematological toxicities associated with amphotericin B formulations.
abstract: Even though amphotericin B is associated with considerable hematological toxicity, this subject has been poorly studied. This retrospective cohort study assessed the incidence and predictors of hematological toxicity in patients treated with different amphotericin B formulations: amphotericin B deoxycholate (d-AmB), liposomal amphotericin B (L-AmB) and amphotericin B lipid complex (ABLC). A total of 497 patients were included. Severe anemia was independently associated with human immunodeficiency virus (HIV) infection (odds ratio [OR] 1.79; 95% confidence interval [CI]: 1.03-3.06). L-AmB use was marginally associated with reduced risk for severe anemia (OR 0.61; CI: 0.32-1.11). Severe leukopenia was associated with ABLC use (OR 2.58; CI: 1.05-6.21) and hematological cancer (OR 4.61; CI: 2.07-10.38). Hematological cancer (OR 5.00; CI 2.79-8.97) was independently associated with risk of severe thrombocytopenia. In this study, significant hematological toxicity was associated with amphotericin B treatment, along with previous hematological disease and use of myelotoxic drugs. Close monitoring is required when managing patients receiving amphotericin B formulations.
authors: a Hospital Nossa Senhora da Conceição , Porto Alegre , Brazil.|b Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre , Brazil.
authors: Diego R
authors: DR
authors: Falci
authors: b Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre , Brazil.
authors: Franciane B
authors: FB
authors: da Rosa
authors: b Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) , Porto Alegre , Brazil.|c Santa Casa de Misericórdia de Porto Alegre , Porto Alegre , Brazil.
authors: Alessandro C
authors: AC
authors: Pasqualotto
mesh_terms: D000328:Adult; D000666:Amphotericin B / Q000008:administration & dosage / Q000009:adverse effects*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002626:Chemistry, Pharmaceutical; D015331:Cohort Studies; D015897:Comorbidity; D003840:Deoxycholic Acid / Q000008:administration & dosage / Q000009:adverse effects; D004338:Drug Combinations; D005260:Female; D006402:Hematologic Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D004338:Drug Combinations; C068538:liposomal amphotericin B; D003840:Deoxycholic Acid; D000666:Amphotericin B; C059765:amphotericin B, deoxycholate drug combination
keywords: Amphotericin B; adverse events; anemia; leukopenia; thrombocytopenia