According to an article recently published in the Annals of Oncology, low doses of amphotercin B used as a preventive measure significantly reduce the risk of fungal infections among patients with hematologic (blood) cancer who have low levels of immune cells for more than 10 days following treatment with chemotherapy.
Hematologic cancers are often treated with intensive regimens of chemotherapy. Often, this approach kills immune cells, leaving patients with low levels of immune cells, referred to as neutropenia. If patients remain neutropenic, their bodies are unable to fight off even mild infections.
Fungal infections are a concern in patients with prolonged neutropenia. Fungal infections often become systemic (full body) and can easily become life-threatening. Amphotericin B is an agent commonly used to treat fungal infections. Researchers are also evaluating ways to prevent fungal infections among patients with neutropenia.
Researchers from Germany recently conducted a clinical trial to evaluate the effectiveness of low doses of liposomal amphotericin B (L-AmB) among patients with hematologic malignancies who were neutropenic for over 10 days. This trial included 219 patients who had been treated with intensive chemotherapy and received either L-AmB or no antifungal preventive measures.
- In the first episode of neutropenia, patients treated with L-AmB had only a 6.7% rate of fungal infections, compared with 35% of patients not receiving preventive antifungal therapy.
- In all episodes of neutropenia, patients treated with L-AmB had a 4.6% rate of fungal infections, compared with 20% of patients not receiving preventive antifungal therapy.
- Side effects possibly associated with L-AmB were observed in 4.6% of patients; no severe side effects were observed.
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The researchers concluded that L-AmB used as a preventive measure appeared highly effective in reducing the risks of developing fungal infections among patients with hematologic cancers who experienced neutropenia due to chemotherapy. Further study is necessary to provide additional insight into the clinical benefits of preventive anti-fungal therapy for these patients.
Patients who have neutropenia may wish to speak with their physician regarding their individual risks and benefits of treatment with preventive anti-fungal therapies.
Reference: Penack O, Schwartz S, Martus P, et al. Low-Dose Liposomal Amphotericin B in the Prevention of Invasive Fungal Infections in Patients with Prolonged Neutropenia: Results from a Randomized, Single-Center Trial. Annals of Oncology. 2006; 17:1306-1312.
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