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Acute Infusion-Related Side Effects of Amphotericin B Lipid Complex (ABLC) in Oncohematological Patients: Real-World Data from Brazilian Reference Centers.

Acute Infusion-Related Side Effects of Amphotericin B Lipid Complex (ABLC) in Oncohematological Patients: Real-World Data from Brazilian Reference Centers.

Authors :
Bridi Cavassin F
Magri MMC
Borgmann AV
Floriani ID
Barreto MR
Zaleski T
de Moraes Costa Carlesse FA
Breda GL
de Araújo Motta F
Falci DR
Mendes AVA
Morales HP
Montes PS
Taborda M
Pereira TTT
Baú-Carneiro JL
Queiroz-Telles F
Source :
Infectious diseases and therapy [Infect Dis Ther] 2025 Jan; Vol. 14 (1), pp. 133-148. Date of Electronic Publication: 2024 Nov 30.
Publication Year :
2025

Abstract

Introduction: Amphotericin B lipid complex (ABLC) is an effective antifungal agent for treating invasive fungal infections (IFIs) even though its formulation is associated with potential adverse events, including those related to its infusion. This study aimed to analyze the incidence of acute infusion-related side effects (IRSE) associated with ABLC and their relationship with the profile of patients with oncohematological disease admitted in Brazilian reference tertiary hospitals.<br />Methods: This is an observational retrospective study that included clinical records of patients hospitalized, in a period of 6 years, diagnosed with probable or proved IFI and treated with at least two doses of ABLC.<br />Results: A total of 229 patients were included, with a male prevalence and an average age of 44 years for adults and 10 years for children. Seventy-nine (34.5%) developed some IRSE, 5.1% of which progressed in severe form to discontinuation of treatment. The most prevalent events in adults were fever (66.7%), tremor/chills (53.3%), and tachycardia (24.4%). In children, the most common were fever (64.7%), tremors/chills (50%), and skin rash/itching (17.6%). Statistical significance was found for premedication use from the first dose of ABLC in relation to the onset of infusion reactions (P = 0.006). Multivariate analysis revealed that ABLC, when compared to liposomal AMB (L-AMB), and neutropenia were associated with a higher risk of developing IRSE (odds ratio [OR] 3.04, P = 0.008; and OR 11.02, P = 0.025, respectively).<br />Conclusions: The use of premedication was a protective factor against the occurrence of IRSE. Therefore, services providing amphotericin B (AMB) must reinforce protocols or implement new measures that optimize tolerability and safety during the treatment of patients with oncohematological disease, with special attention to patients with neutropenia, prioritizing the liposomal formulation of AMB whenever possible.<br />Competing Interests: Declarations. Conflict of Interest: Francelise Bridi Cavassin, Marcello Mihailenko Chaves Magri, Ariela Victoria Borgmann, Isabela Dombeck Floriani, Marina Rachid Barreto, Tania Zaleski, Fabianne Altruda de Moraes Costa Carlesse, Giovanni Luís Breda, Fábio de Araújo Motta, Diego Rodrigues Falci, Ana Verena Almeida Mendes, Hugo Paz Morales, Patrícia Silva Montes, Mariane Taborda, Talita Teles Teixeira Pereira, João Luís Baú-Carneiro, Flávio Queiroz-Telles declare no conflicts of interest for this specific study. Ethical Approval: Consent to use the data was obtained in all centers. Approval was granted by the ethics committees of the seven participating centers, with the Complexo Hospital de Clínicas of the Federal University of Paraná (CHC/UFPR) being the study’s coordinating center.<br /> (© 2024. The Author(s).)

Details

Language :
English
ISSN :
2193-8229
Volume :
14
Issue :
1
Database :
MEDLINE
Journal :
Infectious diseases and therapy
Publication Type :
Academic Journal
Accession number :
39615018
Full Text :
https://doi.org/10.1007/s40121-024-01086-y