Comparative analysis of the nephrotoxicity of liposomal amphotericin B and amphotericin B lipid complex in hematological cancer patients: A multicenter retrospective study

IF 1.6 4区生物学 Q4 MYCOLOGY

Revista Iberoamericana De Micologia Pub Date : 2025-04-01 DOI:10.1016/j.riam.2025.04.003

Susanne Edinger , Edson Abdala , Umran Şumeyse Ertürk , Serhat Çelik , Leylagül Kaynar , Ricardo Rabagliati , Hamid Badali , Ali Amanati , Alexis Manuel Holguin Ruiz , Joseph Meletiadis , Maria Stamouli , Jessica Fernandes Ramos , Alexandre Vargas Schwarzbold , Juan Pablo Caeiro , Guillermo N. Giordano , Maria N. Gamaletsou , Leonardo Filipetto Ferrari , Joao Paulo Telles , Felipe Francisco Tuon , Luiz Cesar Guarita-Souza

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引用次数: 0

Abstract

Background

The incidence rates of acute kidney injury (AKI) associated with amphotericin B lipid complex (ABLC) and liposomal amphotericin B (L-AMB) are inconsistent across studies.

Aims

This study aimed to assess the AKI incidence rates in the largest cohort of patients undergoing ABLC and L-AMB treatment for invasive fungal diseases (IFD) in individuals with hematological cancers.

Methods

This was a multicenter, international, retrospective cohort study involving patients treated with either L-AMB or ABLC for IFD. All patients had a diagnosed malignant hematological disease. Various clinical and epidemiological variables were examined, including the concurrent use of nephrotoxic drugs. The primary outcome was the incidence of AKI.

Results

A total of 637 patients were included in the study, with 294 patients in the ABLC group and 343 patients in the L-AMB group. The most common diagnosis was acute leukemia (56%), followed by lymphoma (22%). The predominant classification of IFD was probable (43%). ABLC was associated with an increased likelihood of inducing grade 1 and 2 nephrotoxicity compared to L-AMB (p < 0.001). Multivariate analysis identified age, vancomycin, and polymyxin use as independent risk factors for AKI. However, serum creatinine levels returned to baseline in 95.3% of patients.

Conclusion

Nephrotoxicity associated with L-AMB was lower than that associated with ABLC in patients with hematological cancer. Most AKI cases were mild to moderate and did not have significant short-term impact.

查看原文本刊更多论文

两性霉素B脂质体和两性霉素B脂质复合物对血液病患者肾毒性的比较分析：一项多中心回顾性研究。

背景：与两性霉素B脂质复合物（ABLC）和两性霉素B脂质体（L-AMB）相关的急性肾损伤（AKI）发生率在研究中不一致。目的：本研究旨在评估血液病患者中接受ABLC和L-AMB治疗侵袭性真菌病（IFD）的最大队列患者的AKI发病率。方法：这是一项多中心、国际、回顾性队列研究，涉及使用L-AMB或ABLC治疗IFD的患者。所有患者均确诊为恶性血液病。检查了各种临床和流行病学变量，包括同时使用肾毒性药物。主要终点是AKI的发生率。结果：共纳入637例患者，其中ABLC组294例，L-AMB组343例。最常见的诊断是急性白血病（56%），其次是淋巴瘤（22%）。IFD的主要分类是可能的（43%）。与L-AMB相比，ABLC与诱导1级和2级肾毒性的可能性增加相关(结论：血液癌患者与L-AMB相关的肾毒性低于与ABLC相关的肾毒性。大多数AKI病例为轻度至中度，没有显著的短期影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista Iberoamericana De Micologia MYCOLOGY-

CiteScore

1.90

自引率

0.00%

发文量

审稿时长

81 days

期刊介绍： Revista Iberoamericana de Micología (Ibero-American Journal of Mycology) is the official journal of the Asociación Española de Micología, Asociación Venezolana de Micología and Asociación Argentina de Micología (The Spanish, Venezuelan, and Argentinian Mycology Associations). The Journal gives priority to publishing articles on studies associated with fungi and their pathogenic action on humans and animals, as well as any scientific studies on any aspect of mycology. The Journal also publishes, in Spanish and in English, original articles, reviews, mycology forums, editorials, special articles, notes, and letters to the editor, that have previously gone through a scientific peer review process.