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Lipid formulations of amphotericin B preserve and stabilize renal function in HSCT recipients.

Publication ,  Journal Article
Miller, CB; Waller, EK; Klingemann, HG; Dignani, MC; Anaissie, EJ; Cagnoni, PJ; McSweeney, P; Fleck, PR; Fruchtman, SM; McGuirk, J; Chao, NJ
Published in: Bone Marrow Transplant
March 2004

The current study assessed renal function based on medical records in adult hematopoietic stem cell transplant (HSCT) recipients with proven or probable invasive fungal infection (IFI) transplanted between 1995 and 2000. We confirm that amphotericin B deoxycholate (AmB-d) is nephrotoxic in a large percentage of HSCT recipients. Due to nephrotoxicity, defined as serum creatinine (SCr) >2.5 mg/dl or a 100% increase in SCr from baseline, 88% of patients treated with AmB-d were switched to a lipid formulation of amphotericin B (LFAB). In total, 53% of patients initiated on AmB-d were switched within the first week of therapy. Significantly more patients (70.6%) treated with AmB-d experienced a 100% increase in SCr from baseline compared to patients treated with either AmBisome (44.4%) or Abelcet (41.2%). A Cox Proportional Hazards Model revealed that, compared to patients initiated on AmBisome or Abelcet, the risk of nephrotoxicity (RR=1.5 vs AmBisome; RR=1.7 vs Abelcet), dialysis (RR=2.4 vs AmBisome; RR=1.4 vs Abelcet), and death (RR=2.0 vs AmBisome; RR=1.1 vs Abelcet) were all increased for patients initiated on AmB-d. Study results suggest that renal function improves and mortality declines when an LFAB is given to HSCT patients as initial therapy rather than as second-line therapy, the current practice.

Duke Scholars

Published In

Bone Marrow Transplant

DOI

ISSN

0268-3369

Publication Date

March 2004

Volume

33

Issue

5

Start / End Page

543 / 548

Location

England

Related Subject Headings

  • Retrospective Studies
  • Proportional Hazards Models
  • Mycoses
  • Middle Aged
  • Male
  • Liposomes
  • Kidney Diseases
  • Kidney
  • Immunology
  • Humans
 

Citation

APA
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MLA
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Miller, C. B., Waller, E. K., Klingemann, H. G., Dignani, M. C., Anaissie, E. J., Cagnoni, P. J., … Chao, N. J. (2004). Lipid formulations of amphotericin B preserve and stabilize renal function in HSCT recipients. Bone Marrow Transplant, 33(5), 543–548. https://doi.org/10.1038/sj.bmt.1704408
Miller, C. B., E. K. Waller, H. G. Klingemann, M. C. Dignani, E. J. Anaissie, P. J. Cagnoni, P. McSweeney, et al. “Lipid formulations of amphotericin B preserve and stabilize renal function in HSCT recipients.Bone Marrow Transplant 33, no. 5 (March 2004): 543–48. https://doi.org/10.1038/sj.bmt.1704408.
Miller CB, Waller EK, Klingemann HG, Dignani MC, Anaissie EJ, Cagnoni PJ, et al. Lipid formulations of amphotericin B preserve and stabilize renal function in HSCT recipients. Bone Marrow Transplant. 2004 Mar;33(5):543–8.
Miller, C. B., et al. “Lipid formulations of amphotericin B preserve and stabilize renal function in HSCT recipients.Bone Marrow Transplant, vol. 33, no. 5, Mar. 2004, pp. 543–48. Pubmed, doi:10.1038/sj.bmt.1704408.
Miller CB, Waller EK, Klingemann HG, Dignani MC, Anaissie EJ, Cagnoni PJ, McSweeney P, Fleck PR, Fruchtman SM, McGuirk J, Chao NJ. Lipid formulations of amphotericin B preserve and stabilize renal function in HSCT recipients. Bone Marrow Transplant. 2004 Mar;33(5):543–548.

Published In

Bone Marrow Transplant

DOI

ISSN

0268-3369

Publication Date

March 2004

Volume

33

Issue

5

Start / End Page

543 / 548

Location

England

Related Subject Headings

  • Retrospective Studies
  • Proportional Hazards Models
  • Mycoses
  • Middle Aged
  • Male
  • Liposomes
  • Kidney Diseases
  • Kidney
  • Immunology
  • Humans