Low dose intravenous infusion of amphotericin B for prevention of fungal infection in patients with acute leukemia

Abstract

The effect of amphotericin B (AMPH) on the prevention of fungal infection in twentyeight patients with acute myeloblastic leukemia (AML) was studied. The patients received a BHAC-DP regimen as consolidation and intensification chemotherapy; Enocitabin (BH-AC) 250mg/day for 7 days, Daunorubicin (DNR) 40mg/day for 3 days, and Prednisolone (PSL) 30mg/day for 7 days. Intravenous infusion (i. v.) of AMPH (0.15 mg/kg/day) was dosed, in addition to oral administration of AMPH (2,400mg/day), in 41 treatment periods in patients with AML (i. v. infusion group). Oral AMPH alone was administered, in 38 treatment periods, to patients with AML (oral administration group). The period of apyrexia, the period of fever, C reactive protein (CRP), erythrocyte sedimentation rate (ESR), culture data, incidence of adverse effects, and the quantity of endotoxin were compared between the two groups. The ENT. infusion group showed signififcantly better results than the oral administration group; the period of fever was significantly shorter (2.7 •} 3.5 days, p < 0.05), and serious systemic fungal infection was less offen detected (0 cases) than in the oral administration group (3 cases). No serious adverse events were observed.