AMPHOTERICIN-B COLLOIDAL DISPERSION VS AMPHOTERICIN-B AS THERAPY FOR INVASIVE ASPERGILLOSIS

To assess the efficacy and safety of amphotericin B colloidal dispersi on (ABCD), 82 patients with proven or probable aspergillosis who were treated in clinical trials with ABCD were compared retrospectively wit h 261 patients with aspergillosis who were treated with amphotericin B at six cancer or transplant centers from January 1990 to June 1994. T he groups were balanced in terms of underlying disease; ABCD recipient s were younger and more likely to have preexisting renal insufficiency than were amphotericin B recipients (40.7% vs. 8.7%, respectively), a nd amphotericin B recipients were more likely to be neutropenic at bas eline than were ABCD recipients (42.5% vs, 15.9%, respectively), Respo nse rates (48.8%) and survival rates (50%) among ABCD-treated patients were higher than those (23.4% and 28.4%, respectively) among amphoter icin B-treated patients (P < .001 for both comparisons), Renal dysfunc tion developed less frequently in ABCD recipients than in amphotericin B recipients (8.2% vs. 43.1%, respectively; P < .001), Multivariate a nalysis revealed that treatment group was the best predictor of respon se, mortality, and nephrotoxicity (ABCD: relative risk [RR] = 3.00, P = .002; RR = 0.35, P < .001; and RR = 0.13, P = .001; respectively). T his retrospective study suggests that in the treatment of aspergillosi s ABCD causes fewer nephrotoxic effects than amphotericin B and the ef ficacy of ABCD is at least comparable with that of amphotericin B.