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Titolo:
Liposomal amphotericin B (AmBisome) in children with febrile neutropenia and renal dysfunction
Autore:
Chisholm, J; Devine, T; Mycroft, J; Pinkerton, CR;
Indirizzi:
Royal Marsden NHS Trust, Dept Paediat Oncol, Sutton SM2 5PT, Surrey, England Royal Marsden NHS Trust Sutton Surrey England SM2 5PT PT, Surrey, England Royal Marsden NHS Trust, Dept Pharm, Sutton SM2 5PT, Surrey, England RoyalMarsden NHS Trust Sutton Surrey England SM2 5PT PT, Surrey, England
Titolo Testata:
INTERNATIONAL JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY
fascicolo: 3, volume: 6, anno: 1999,
pagine: 173 - 182
SICI:
1070-2903(1999)6:3<173:LAB(IC>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
INVASIVE FUNGAL-INFECTIONS; MARROW TRANSPLANT RECIPIENTS; COLLOIDAL DISPERSION; LIPID COMPLEX; SAFETY; TOXICITY; THERAPY; NEPHROTOXICITY; EXPERIENCE; EFFICACY;
Keywords:
amphotericin B; AmBisome; nephrotoxicity; hypokalaemia;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Pinkerton, CR Royal Marsden NHS Trust, Dept Paediat Oncol, Downs Rd, Sutton SM2 5PT, Surrey, England Royal Marsden NHS Trust Downs Rd Sutton Surrey England SM2 5PT
Citazione:
J. Chisholm et al., "Liposomal amphotericin B (AmBisome) in children with febrile neutropenia and renal dysfunction", INT J PED H, 6(3), 1999, pp. 173-182

Abstract

Purpose Lipid-based Amphotericin B preparations have been developed to improve drug targeting and reduce toxicity. Although increasingly used, littlepublished information is available on liposomal Amphotericin B (AmBisome) in children with established renal impairment on treatment for febrile neutropenia. The purpose of this study was to examine the nephrotoxicity of AmBisome in children with malignant disease with established renal impairment. Patients and Methods This retrospective study examined 17 episodes of AmBisome use (3 mg/kg/day) in 14 febrile, neutropenic children with establishedglomerular or tubular impairment. The findings are contrasted with resultsfrom 25 episodes of Amphotericin B use (1 mg/kg/day) in 24 children with normal renal function receiving antifungal treatment for similar reasons. Results Mean creatinine was stable in patients receiving AmBisome but increased significantly in those on Amphotericin B. Doubling of serum creatinine was seen in no patient receiving AmBisome, in contrast to 20% of patientson Amphotericin B. In both groups mean serum potassium was stable but potassium supplementation rose significantly. The rise in potassium supplementation became significant earlier in the Amphotericin B group than in the AmBisome group (day 2 vs. day 7). Despite the use of AmBisome, profound hypokalaemia (< 2.5 mmol/I) occurred in 18% of patients. Conclusions Further decline in glomerular function was rare in children with cancer receiving AmBisome. Potassium wasting was seen with both AmBisomeand conventional Amphotericin B but in high-risk patients receiving AmBisome deterioration was similar to that occurring in children with normal renal function receiving Amphotericin B.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/09/20 alle ore 08:09:16