title: Safety and efficacy of treatment with liposomal amphotericin B in elderly patients at least 65 years old with hematological diseases.
abstract: The safety and efficacy of treatment with liposomal amphotericin B (L-AMB) in elderly patients has not been clarified, especially in Japanese patients. Therefore, we retrospectively analyzed 33 elderly patients with hematological diseases of at least 65 years old who received L-AMB between 2009 and 2012. Their clinical outcomes were compared to those of 21 patients who were younger than 65 years. L-AMB was administered for empirical therapy (n = 2) or target therapy for possible (n = 14) or probable/proven (n = 17) invasive fungal infection. There was no discontinuation of L-AMB due to adverse events. More than 2-fold increases from the baseline Cre, AST, and ALT values were observed in 21.2%, 39.4%, and 45.5% of the older group and 38.1%, 61.9%, and 52.4% of the younger group, respectively. The concurrent use of nephrotoxic antibiotics was the only risk factor for the development of a 2-fold increase in the serum Cre level. The duration of L-AMB was significantly longer in patients who developed grade III-IV hypokalemia. A partial or complete response was observed in 54.8% and 62.5% of the elderly and younger groups, respectively. In conclusion, L-AMB therapy appeared to be acceptably safe as empirical therapy or treatment for invasive fungal infection.
authors.affiliation: Department of Hematology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaemachi, Itabashi-ku, Tokyo 173-0015, Japan; Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847 Amanumacho, Omiya-ku, Saitama-shi, Saitama 330-8503, Japan.
authors.forename: Satomi
authors.initials: S
authors.lastname: Ueda
authors.affiliation: Department of Pharmacy, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaemachi, Itabashi-ku, Tokyo 173-0015, Japan.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Miyamoto
authors.affiliation: Department of Pharmacy, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaemachi, Itabashi-ku, Tokyo 173-0015, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kaida
authors.affiliation: Department of Hematology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaemachi, Itabashi-ku, Tokyo 173-0015, Japan.
authors.forename: Aki
authors.initials: A
authors.lastname: Chizuka
authors.affiliation: Department of Hematology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaemachi, Itabashi-ku, Tokyo 173-0015, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Kojima
authors.affiliation: Department of Hematology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaemachi, Itabashi-ku, Tokyo 173-0015, Japan.
authors.forename: Junichiro
authors.initials: J
authors.lastname: Takano
authors.affiliation: Department of Hematology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaemachi, Itabashi-ku, Tokyo 173-0015, Japan.
authors.forename: Toshie
authors.initials: T
authors.lastname: Ogasawara
authors.affiliation: Department of Chemotherapy, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaemachi, Itabashi-ku, Tokyo 173-0015, Japan.
authors.forename: Ko
authors.initials: K
authors.lastname: Miyamoto
authors.affiliation: Department of Hematology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaemachi, Itabashi-ku, Tokyo 173-0015, Japan.
authors.forename: Shigesaburo
authors.initials: S
authors.lastname: Miyakoshi
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847 Amanumacho, Omiya-ku, Saitama-shi, Saitama 330-8503, Japan. Electronic address: ycanda-tky@umin.ac.jp.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kanda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000666:Amphotericin B / Q000009:adverse effects* / Q000627:therapeutic use; D000935:Antifungal Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006402:Hematologic Diseases / Q000150:complications*; D006801:Humans; D016867:Immunocompromised Host; D000072742:Invasive Fungal Infections / Q000188:drug therapy* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D000935:Antifungal Agents; C068538:liposomal amphotericin B; D000666:Amphotericin B
keywords: Creatinine; Elderly patients; Hypokalemia; Invasive fungal infection; Liposomal amphotericin B