Safety analysis of liposomal amphotericin B in adult patients: Anaemia, thrombocytopenia, nephrotoxicity, hepatotoxicity and hypokalaemia

Akari Shigemi, Kazuaki Matsumoto, Kazuro Ikawa, Keiko Yaji, Yoshihiro Shimodozono, Norifumi Morikawa, Yasuo Takeda, Katsushi Yamada

研究成果: Article

19 引用 (Scopus)

抄録

Liposomal amphotericin B (L-AmB), which was developed to reduce side effects, has been shown to have a better safety profile than both the deoxycholate and lipid complex forms of amphotericin B; however, the frequency of major side effects is still unclear. Thus, the aim of the present study was to assess retrospectively the frequency of L-AmB-induced anaemia, thrombocytopenia, nephrotoxicity, hepatotoxicity and hypokalaemia as well as the relationship between daily dose of L-AmB and these side effects. A low red blood cell (RBC) count (post-/pre-treatment) and anaemia were observed in 7 and 10 of 21 adult patients, respectively. Thrombocytopenia was observed in 11 of 19 adult patients. Doses of L-AmB that are estimated to cause side effects of a low RBC count, anaemia and thrombocytopenia with 50% probability are 4.0, 3.3 and 3.0 mg/kg/day, respectively. Nephrotoxicity was observed in 6 of 22 patients. Variations of total bilirubin, γ-glutamyl transpeptidase, aspartate aminotransferase and alanine aminotransferase used as indices of hepatotoxicity were observed in 6, 7, 8 and 8 of 22 patients, respectively. Hypokalaemia was observed in 4 of 9 patients; however, nephrotoxicity, hepatotoxicity and hypokalaemia were not caused in a dose-dependent manner. In conclusion, the present analyses showed that L-AmB dose-dependently induced anaemia and thrombocytopenia in adult patients. It is important to pay attention to causing anaemia and thrombocytopenia when patients are receiving L-AmB at doses of >3.3 mg/kg/day and >3.0 mg/kg/day, respectively.

元の言語English
ページ(範囲)417-420
ページ数4
ジャーナルInternational Journal of Antimicrobial Agents
38
発行部数5
DOI
出版物ステータスPublished - 2011 11
外部発表Yes

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Hypokalemia
Thrombocytopenia
Anemia
Safety
Erythrocyte Count
Deoxycholic Acid
gamma-Glutamyltransferase
Aspartate Aminotransferases
liposomal amphotericin B
Alanine Transaminase
Bilirubin

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

これを引用

Safety analysis of liposomal amphotericin B in adult patients : Anaemia, thrombocytopenia, nephrotoxicity, hepatotoxicity and hypokalaemia. / Shigemi, Akari; Matsumoto, Kazuaki; Ikawa, Kazuro; Yaji, Keiko; Shimodozono, Yoshihiro; Morikawa, Norifumi; Takeda, Yasuo; Yamada, Katsushi.

:: International Journal of Antimicrobial Agents, 巻 38, 番号 5, 11.2011, p. 417-420.

研究成果: Article

Shigemi, Akari ; Matsumoto, Kazuaki ; Ikawa, Kazuro ; Yaji, Keiko ; Shimodozono, Yoshihiro ; Morikawa, Norifumi ; Takeda, Yasuo ; Yamada, Katsushi. / Safety analysis of liposomal amphotericin B in adult patients : Anaemia, thrombocytopenia, nephrotoxicity, hepatotoxicity and hypokalaemia. :: International Journal of Antimicrobial Agents. 2011 ; 巻 38, 番号 5. pp. 417-420.
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abstract = "Liposomal amphotericin B (L-AmB), which was developed to reduce side effects, has been shown to have a better safety profile than both the deoxycholate and lipid complex forms of amphotericin B; however, the frequency of major side effects is still unclear. Thus, the aim of the present study was to assess retrospectively the frequency of L-AmB-induced anaemia, thrombocytopenia, nephrotoxicity, hepatotoxicity and hypokalaemia as well as the relationship between daily dose of L-AmB and these side effects. A low red blood cell (RBC) count (post-/pre-treatment) and anaemia were observed in 7 and 10 of 21 adult patients, respectively. Thrombocytopenia was observed in 11 of 19 adult patients. Doses of L-AmB that are estimated to cause side effects of a low RBC count, anaemia and thrombocytopenia with 50{\%} probability are 4.0, 3.3 and 3.0 mg/kg/day, respectively. Nephrotoxicity was observed in 6 of 22 patients. Variations of total bilirubin, γ-glutamyl transpeptidase, aspartate aminotransferase and alanine aminotransferase used as indices of hepatotoxicity were observed in 6, 7, 8 and 8 of 22 patients, respectively. Hypokalaemia was observed in 4 of 9 patients; however, nephrotoxicity, hepatotoxicity and hypokalaemia were not caused in a dose-dependent manner. In conclusion, the present analyses showed that L-AmB dose-dependently induced anaemia and thrombocytopenia in adult patients. It is important to pay attention to causing anaemia and thrombocytopenia when patients are receiving L-AmB at doses of >3.3 mg/kg/day and >3.0 mg/kg/day, respectively.",
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AU - Yaji, Keiko

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AU - Morikawa, Norifumi

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