Once-weekly liposomal amphotericin B for prophylaxis of invasive fungal infection after graft-versus-host disease in allogeneic hematopoietic stem cell transplantation: A comparative retrospective single-center study

Jean El Cheikh, Luca Castagna, Ling Wang, Benjamin Esterni, Catherine Faucher, Sabine Furst, Segolene Duran, Pierre Berger, Stephane Ranque, Mohamad Mohty, Didier Blaise

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

BACKGROUND AND OBJECTIVES: The liposomal formulation of amphotericin B (LAmB) has been shown to cause few and mild infusion-related reactions, while achieving high plasma and tissue concentrations compared with conventional amphotericin B. We investigated the efficacy and safety of high-dose LAmB (7.5 mg/kg once weekly) prophylaxis of fungal infections in allogeneic stem-cell transplanted (allo-SCT) patients with graft-versus-host disease (GvHD). DESIGN AND SETTING: Retrospective, comparative, single-center. METHODS: Forty-two patients receiving high-dose prednisone for GvHD after allo-SCT had LAmB prophylaxis; 83 patients in the control group received other antifungal prophylaxis. RESULTS: In the LAmB prophylaxis group, the median duration of treatment was 7 weeks. The cumulative incidence of invasive fungal infection was 8% at 1 year after transplantation, 8% at 2 years and 16% at 3 years in the LAmB group vs. 36% at 1 year, 44% at 2 years and 49% at 3 years in the other prophylaxis group (P=.008). Fungal infection-related mortality after transplantation was observed in none of the patients in the LAmB prophylaxis group vs. 12 patients (14%) at 1 year, 14 patients (17%) at 2 years and 16 patients (19%) at 3 years in the control group (P=.005). The tolerance of the treatment was good with only 5 patients (12%) having a reversible nephrotoxicity leading to temporary treatment discontinuation. CONCLUSIONS: High-dose LAmB prophylaxis seems effective and well tolerated in this short series of allo-SCT patients with GvHD. Prospective clinical studies are required to confirm these results.

Original languageEnglish
Pages (from-to)167-173
Number of pages7
JournalHematology/ Oncology and Stem Cell Therapy
Volume3
Issue number4
DOIs
Publication statusPublished - 2010

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Hematopoietic Stem Cell Transplantation
Graft vs Host Disease
Stem Cells
Mycoses
Transplantation
liposomal amphotericin B
Invasive Fungal Infections
Control Groups
Amphotericin B
Prednisone
Therapeutics
Prospective Studies
Safety
Mortality
Incidence

ASJC Scopus subject areas

  • Hematology
  • Oncology

Cite this

Once-weekly liposomal amphotericin B for prophylaxis of invasive fungal infection after graft-versus-host disease in allogeneic hematopoietic stem cell transplantation : A comparative retrospective single-center study. / El Cheikh, Jean; Castagna, Luca; Wang, Ling; Esterni, Benjamin; Faucher, Catherine; Furst, Sabine; Duran, Segolene; Berger, Pierre; Ranque, Stephane; Mohty, Mohamad; Blaise, Didier.

In: Hematology/ Oncology and Stem Cell Therapy, Vol. 3, No. 4, 2010, p. 167-173.

Research output: Contribution to journalArticle

El Cheikh, Jean ; Castagna, Luca ; Wang, Ling ; Esterni, Benjamin ; Faucher, Catherine ; Furst, Sabine ; Duran, Segolene ; Berger, Pierre ; Ranque, Stephane ; Mohty, Mohamad ; Blaise, Didier. / Once-weekly liposomal amphotericin B for prophylaxis of invasive fungal infection after graft-versus-host disease in allogeneic hematopoietic stem cell transplantation : A comparative retrospective single-center study. In: Hematology/ Oncology and Stem Cell Therapy. 2010 ; Vol. 3, No. 4. pp. 167-173.
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abstract = "BACKGROUND AND OBJECTIVES: The liposomal formulation of amphotericin B (LAmB) has been shown to cause few and mild infusion-related reactions, while achieving high plasma and tissue concentrations compared with conventional amphotericin B. We investigated the efficacy and safety of high-dose LAmB (7.5 mg/kg once weekly) prophylaxis of fungal infections in allogeneic stem-cell transplanted (allo-SCT) patients with graft-versus-host disease (GvHD). DESIGN AND SETTING: Retrospective, comparative, single-center. METHODS: Forty-two patients receiving high-dose prednisone for GvHD after allo-SCT had LAmB prophylaxis; 83 patients in the control group received other antifungal prophylaxis. RESULTS: In the LAmB prophylaxis group, the median duration of treatment was 7 weeks. The cumulative incidence of invasive fungal infection was 8{\%} at 1 year after transplantation, 8{\%} at 2 years and 16{\%} at 3 years in the LAmB group vs. 36{\%} at 1 year, 44{\%} at 2 years and 49{\%} at 3 years in the other prophylaxis group (P=.008). Fungal infection-related mortality after transplantation was observed in none of the patients in the LAmB prophylaxis group vs. 12 patients (14{\%}) at 1 year, 14 patients (17{\%}) at 2 years and 16 patients (19{\%}) at 3 years in the control group (P=.005). The tolerance of the treatment was good with only 5 patients (12{\%}) having a reversible nephrotoxicity leading to temporary treatment discontinuation. CONCLUSIONS: High-dose LAmB prophylaxis seems effective and well tolerated in this short series of allo-SCT patients with GvHD. Prospective clinical studies are required to confirm these results.",
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T1 - Once-weekly liposomal amphotericin B for prophylaxis of invasive fungal infection after graft-versus-host disease in allogeneic hematopoietic stem cell transplantation

T2 - A comparative retrospective single-center study

AU - El Cheikh, Jean

AU - Castagna, Luca

AU - Wang, Ling

AU - Esterni, Benjamin

AU - Faucher, Catherine

AU - Furst, Sabine

AU - Duran, Segolene

AU - Berger, Pierre

AU - Ranque, Stephane

AU - Mohty, Mohamad

AU - Blaise, Didier

PY - 2010

Y1 - 2010

N2 - BACKGROUND AND OBJECTIVES: The liposomal formulation of amphotericin B (LAmB) has been shown to cause few and mild infusion-related reactions, while achieving high plasma and tissue concentrations compared with conventional amphotericin B. We investigated the efficacy and safety of high-dose LAmB (7.5 mg/kg once weekly) prophylaxis of fungal infections in allogeneic stem-cell transplanted (allo-SCT) patients with graft-versus-host disease (GvHD). DESIGN AND SETTING: Retrospective, comparative, single-center. METHODS: Forty-two patients receiving high-dose prednisone for GvHD after allo-SCT had LAmB prophylaxis; 83 patients in the control group received other antifungal prophylaxis. RESULTS: In the LAmB prophylaxis group, the median duration of treatment was 7 weeks. The cumulative incidence of invasive fungal infection was 8% at 1 year after transplantation, 8% at 2 years and 16% at 3 years in the LAmB group vs. 36% at 1 year, 44% at 2 years and 49% at 3 years in the other prophylaxis group (P=.008). Fungal infection-related mortality after transplantation was observed in none of the patients in the LAmB prophylaxis group vs. 12 patients (14%) at 1 year, 14 patients (17%) at 2 years and 16 patients (19%) at 3 years in the control group (P=.005). The tolerance of the treatment was good with only 5 patients (12%) having a reversible nephrotoxicity leading to temporary treatment discontinuation. CONCLUSIONS: High-dose LAmB prophylaxis seems effective and well tolerated in this short series of allo-SCT patients with GvHD. Prospective clinical studies are required to confirm these results.

AB - BACKGROUND AND OBJECTIVES: The liposomal formulation of amphotericin B (LAmB) has been shown to cause few and mild infusion-related reactions, while achieving high plasma and tissue concentrations compared with conventional amphotericin B. We investigated the efficacy and safety of high-dose LAmB (7.5 mg/kg once weekly) prophylaxis of fungal infections in allogeneic stem-cell transplanted (allo-SCT) patients with graft-versus-host disease (GvHD). DESIGN AND SETTING: Retrospective, comparative, single-center. METHODS: Forty-two patients receiving high-dose prednisone for GvHD after allo-SCT had LAmB prophylaxis; 83 patients in the control group received other antifungal prophylaxis. RESULTS: In the LAmB prophylaxis group, the median duration of treatment was 7 weeks. The cumulative incidence of invasive fungal infection was 8% at 1 year after transplantation, 8% at 2 years and 16% at 3 years in the LAmB group vs. 36% at 1 year, 44% at 2 years and 49% at 3 years in the other prophylaxis group (P=.008). Fungal infection-related mortality after transplantation was observed in none of the patients in the LAmB prophylaxis group vs. 12 patients (14%) at 1 year, 14 patients (17%) at 2 years and 16 patients (19%) at 3 years in the control group (P=.005). The tolerance of the treatment was good with only 5 patients (12%) having a reversible nephrotoxicity leading to temporary treatment discontinuation. CONCLUSIONS: High-dose LAmB prophylaxis seems effective and well tolerated in this short series of allo-SCT patients with GvHD. Prospective clinical studies are required to confirm these results.

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