Onkologie. 2009:3(4):219-222

Infusion - related acute reaction in patient receiving different forms of Amphotericin B

Renata Foralová¹, MUDr. Peter Múdry¹, Lenka Dubská², Michal Kýr¹, Stefan Weiler³, Romuald Bellmann³, Dalibor Valík⁴, prof. MUDr. Jaroslav Štěrba Ph.D¹

¹ Klinika dětské onkologie LF MU a FN, Brno

² Oddělení laboratorní medicíny Masarykův onkologický ústav Brno

³ Department of Internal Medicine, Inflammation Research Laboratory, Innsbruck Medical School

⁴ Masarykův onkologický ústav, Brno

The invasive mycotic infections belong to serious life- threatening diseases. The therapy using different forms of Amphotericin B (AmB)

improved treatment outcomes for immunocompromised patients with invasive mycosis (1). Recently the mortality for invasive mycosis

is lower then it was before AmB introduction (1), however the acute and even the late nephrotoxicity of AmB as well as the Infusion- related

reaction (IRR) limit its use in clinical practice. The choice of AmB´s form and the adequate supportive care (hyperhydratation) can

minimize the AmB´s nephrotoxicity (2). There was an endeavor to pre-medicate patients to minimize fevers, chills and rigor as IRR´s most

common symptoms. But there were almost no successful results except steroids. Only corticosteroids are known to be able to decrease

IRR´s incidence (3). Because of just limited knowledge of IRR´s pathogenesis and almost no prospective studies there is a need of more

clinical data. The prospective study in pediatric oncology patients treated with AmB was initiated in order to improve our understanding

of IRRs. Flowcytometric measurement of lymphocytes´ subpopulations and plasma cytokines´ levels in comparison with plasmatic AmB

levels, clinical incidence of IRRs, type of AmB and type of premedication point out the causal nexus among the changes of a count of

Th-memory effectors, cytokine levels and the incidence of IRR.

Keywords: Amphotericin B, toxicity, invasive mycosis, acute averse event.

Published: November 1, 2009  Show citation