EXPERIENCE WITH LIPOSOMAL AMPHOTERICIN-B IN 60 PATIENTS UNDERGOING HIGH-DOSE THERAPY AND BONE-MARROW OR PERIPHERAL-BLOOD STEM-CELL TRANSPLANTATION

60 patients undergoing bone marrow or stem cell transplantation were treated with liposomal Amphotericin-B for documented or suspected mycosis. 34 patients had a prior course of conventional Amphotericin-B with the following adverse effects: increasing creatinine above 1.4 mg/dl (n=17), increasing creatinine below 1.5 mg/dl (n=9), no response (n=6), and clinical side-effects (n=4). Liposomal Amphotericin-B failed in 6/7 patients with culture-proven mycosis who died fi om infection with Aspergillus (n=2) and Canadida (n=4), respectively. One patient with Candida lambica sepsis was cured. No patient with clinically or serologically suspected or diagnosed infection died from mycosis. Liposomal Amphotericin-B was well tolerated in 57 patients, even after side-effects of the conventional formulation. Adverse effects occurred in three cases, requiring the withdrawal of the drug in one patient, Due to toxic side-effects of the high-dose therapy and transplant-related complications, it was difficult to evaluate the influence of liposomal Amphotericin-B on laboratory parameters. Eight patients showed a decrease of creatinine levels, which had increased above normal values under preceding therapy with conventional Amphotericin-B. Liposomal Amphotericin-B is well tolerated in patients undergoing high-dose therapy and bone marrow transplantation, The efficacy of liposomal Amphotericin-B needs to be investigated in randomized studies in comparison with conventional Amphotericin-B.