Evaluation of the Efficacy of Liposomal Amphotericin B

IYAMA Satoshi, MURASE Kazuyuki, SATO Tsutomu, KIKUCHI Shohei, SATO Yasushi, KOBUNE Masayoshi, TAKIMOTO Risyu, KATO Junji

doi:10.11150/kansenshogakuzasshi.84.182

A retrospective study was performed to evaluate the efficacy and safety of liposomal amphotericin B (L-AMB) in a total of 32 cases who were among patients hospitalized at the Fourth Department of Internal Medicine, Sapooro Medical University from December 2006 to April 2008. Primary diagnoses were hematologic diseases in 87.5％of subjects. The most common hematologic diseases included acute myelogenous leukemia in 50％of the subjects, followed by malignant lymphoma in 12.5％of the subjects. The mean administration period was 14.2±12.9 days, and the mean cumulative dose was 1,786±2,181 mg. L-AMB improved 21 of 29 cases (72.4％) with some fungal infections or fever-associated neutropenia. Adverse events occurred in 9 cases to a slight degree, in 7 cases to a moderate degree, and in no case to a severe degree. Hypokalemia and hypercreatininemia were seen in 7 cases (21.9％) and 4 cases (12.5％), respectively, but these adverse reactions were so mild that the treatment did not need to be discontinued. Any adverse reactions for which treatment administration was discontinued were confirmed to have disappeared at the end of the study. These results support the efficacy and safety of L-AMB in accordance with previous foreign reports. It was noteworthy that early use of L-AMB prior to established diagnosis sometimes better therapeutic outcomes. It was also suggested that L-AMB could be safely administered while controlling electrolyte balance, such as serum potassium concentration, with sufficient fluid replacement, including physiological saline infusion. There are limitations in the use of the conventional form of amphotericin B because of its renal toxicity and other reasons. However, L-AMB had fewer side effects, so the agent was considered useful for the treatment of hematologic disease patients who either had mycosis or carried a risk for fungal infection.

Evaluation of the Efficacy of Liposomal Amphotericin B

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