Use of liposomal amphotericin B in bone marrow transplant.
P. S Sastry, PM Parikh, PS Kulkarni, R Bhagwat, H Gadade
Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
Increasing number of transplants worldwide has resulted in an increase in the incidence of fungal infections. Prolonged neutropenia, immunosuppression and graft vs. host disease all result in high predisposition to fungal infections. The likelihood of developing a fungal infection increases with the severity and duration of neutropenia, which, in the case of cancer or chemotherapy for the treatment of hematological malignancies, can range from a few days to several weeks. Invasive fungal infections are difficult to diagnose and neutropenic patients with fever often receive empirical antifungal therapy. This provides a rationale for the prophylactic use of antifungal agents. The empirical use of liposomal amphotericin B has overcome some of the difficulties usually found in this setting. The majority of clinical efficacy data related to liposomal amphotericin B are derived from compassionate use studies and case series. The major advantage of these liposomal formulations of amphotericin B is a reduction in amphotercin toxicity. Use of liposomal amphotericin has been shown to be a cost-effective approach abroad and the same has been our experience also. Commercially ambisome and Fungisome are the only products that contain true liposomes. Unlike ambisome, which needs to be used in dose of 3 mg/kg/day FungisomeTM is effective in the dose of 1-3 mg/kg bodyweight. The Indian liposomal preparation has shown to be safe and effective used in over 150 transplant patients in our experience. We conclude that the liposomal amphotericin is better-tolerated and also gives better responses in documented fungal infections.
P M Parikh
Department of Medical Oncology, Tata Memorial Hospital, Mumbai
|How to cite this article:|
Sastry P, Parikh P M, Kulkarni P S, Bhagwat R, Gadade H. Use of liposomal amphotericin B in bone marrow transplant. J Postgrad Med 2005;51:49-52
|How to cite this URL:|
Sastry P, Parikh P M, Kulkarni P S, Bhagwat R, Gadade H. Use of liposomal amphotericin B in bone marrow transplant. J Postgrad Med [serial online] 2005 [cited 2020 Nov 26 ];51:49-52
Available from: https://www.jpgmonline.com/article.asp?issn=0022-3859;year=2005;volume=51;issue=5;spage=49;epage=52;aulast=Sastry;type=0