Efficacy of low dose amphotericin B for treating invasive fungal infection in hematologic malignancies / 中国综合临床

ABSTRACT

Objective To investigate the efficacy and safety of low dose amphotericin B for treating invasive fungal infection (IFI) in hematologic malignancies.Methods Ninety-eight patients with hematologic diseases who visited our hospital from January 2008 to June 2012 were randomly divided into the control group (n =47) and the treatment group(n =51).Patients in the control group were treated with amphotericin B,50-60 mg per day and patients in treatment group were given amphotericin B,25-30 mg per day.Clinical efficacy and side effects were compared between the two groups.Results There was no significant difference on the median cumulative dose between the control group and the treatment group(725 (175,1595) mg vs 735 (225,1485) mg,P =0.834).But there was significant difference on median treatment days between the control group and the treatment group(19(8,34) d vs 29(11,58) d,P =0.000).After treatment for 14 days,the patients who can be evaluated for efficacy were 37 and 48 cases respectively in the control group and in the treatment group,and there was no significant difference on the total efficacy rate,the rate of progress and the rate of fever between the control group and the treatment group (all P ＞ 0.05).There were 14 patients and 6 patients terminated treatment because of adverse reaction,and the difference was significant (29.8％ vs 11.8％,P =0.027).The side effect rates of hepatic and renal impairment in the control group was significantly higher than that in the treatment group(27.7％ (13/47) vs 11.8％ (6/51),P =0.047).Conclusion The efficacy of 25-30 mg per day's amphotericin B treatment is not lower than amphotericin B at 50-60 mg per day on IFI in hematologic malignancies.It is not only relatively safe and less expensive,but also operability and practicality in the treatment of IFI.