Clinical Analysis Of 111 Cases Of Hematologic Malignancy Complicating With Invasive Fungal Infections Treated By Amphotericin B Or Its Liposome

Background:With the application of high-dose chemotherapy,organ transplantation, glucocorticoid,immunosuppressive drugs and the application of broad-spectrum antibiotics,the incidence of invasive fungal infections(IFI)in patients with hematologic diseases has increased gradually.Despite the obvious effect of second-generation azole drugs such as voriconazole and anti-fungal agent Caspofungin,but their high cost limits in its clinical application.Domestic amphotericin B and amphotericin B liposome are still widely used,both the efficacy and safety need to be further analyzed.We have used domestic amphotericin B and amphotericin B liposome treated 111 patients with hematologic malignancy complicating with IFI,summarized and compared the clinical efficacy and adverse reactions.Object:Analyse the clinical features of patients with hematologic diseases complicating with IFI.Compare the differences on clinical therapeutic effect and safety of inject amphotericin B and amphotericin B liposome in treating hematologic malignancy with IFI.Methods:Collect the informations of patients in hospital from 2000.6 to 2006.6 with the following conditions:these patients all have hematologic malignancy complicating with IFI(according to"the diagnostic criteria and therapeutic principle of patients with hematologic disease/malignancy complicating with IFI" Revised edition),and are treated by inject amphotericin B or amphotericin B liposome.Analyse the clinical features of patients and compare therapeutic effect and safety of inject amphotericin B and its liposome.Results:The main disease in hematologic malignancy with IFI is acute leukemia.Cases of final diagnosis,clinical diagnosis and tentative diagnosis are 8,28 and 75,accounting for 7%,25%and 68%respectively.91 cases of pulmanary infection,accounting for 82%, 42 cases of positive fungal culture,accounting for 38%.The clinical total effective rate of amphotericin B group and its liposome group is 69%and 58%respectively.There is no significant deviation between the two groups(p＞0.05).In adverse reactions,the incidence rate of shiver and fever is 21%,10%,hypopotassemia is 34%,14%,hepatic impairment is 22%,17%,renal impairment is 9%,3%respectively.There is no significant deviation(p＞0.05)of adverse effects between the two groups excepting hypopotassemia (p=0.03).Conclusions:The main disease in hematologic malignancy with IFI is acute leukemia. Pulmanary infection is the most seen occurrence.Most patients are diagnosed by tentative diagnosis.Amphotericin B is an active drug in treating IFI,most adverse reaction can be controlled if used reasonablely.The therapeutic effect of amphotericin B and its liposome is similar.The severe adverse reaction of amphotericin B liposome is slightly lower than amphotericin B.