# Clinical efficacy and safety of liposomal amphotericin B in the salvage treatment of invasive fungal disease in patients with hematological diseases

## TL;DR

This study shows that liposomal amphotericin B is effective and safe for treating fungal infections in blood disease patients who didn't respond to previous treatments.

## Contribution

Demonstrates the clinical effectiveness and safety profile of liposomal amphotericin B as salvage therapy for invasive fungal disease in hematological patients.

## Key findings

- L-AmB showed a 77.5% efficacy rate in salvage treatment of IFD in hematological patients.
- Disease remission status and treatment duration were significant predictors of L-AmB effectiveness.
- Adverse effects were mostly mild, with low rates of severe kidney toxicity and infusion reactions.

## Abstract

探究两性霉素B脂质体（Liposomal amphotericin B，L-AmB）在血液病患者中挽救性治疗侵袭性真菌病（invasive fungal disease，IFD）的疗效及安全性。

回顾性收集既往抗真菌治疗失败后2023年6月至2023年12月期间于苏州弘慈血液病医院血液科接受L-AmB治疗的80例血液病患者资料。统计患者基本信息、临床疗效，应用Logistic回归分析影响L-AmB疗效的因素。

80例血液病患者中，确诊IFD 9例（11.2％），临床诊断IFD 43例（53.8％），拟诊IFD 28例（35.0％）。L-AmB挽救性治疗有效率为77.5％，中位每日剂量3（1～5）mg·kg−1·d−1，中位用药疗程14（8，25）d。多因素Logistic回归分析显示：疾病缓解状态（OR＝4.337，95％ CI 1.167～16.122，P＝0.029）和用药疗程（OR＝1.127，95％ CI 1.029～1.234，P＝0.010）是影响L-AmB疗效的独立因素。L-AmB相关输液反应包括发热和寒战（5.0％）。低钾血症发生率为28.8％，主要为1～2级。肾毒性发生率为11.3％，主要为1～2级。

L-AmB治疗既往抗真菌治疗不耐受或无效的IFD患者安全有效，不良反应率低。