Treatment of mycotic infections after haemopoietic progenitor cell transplantation with liposomal amphotericin-B

115 patients undergoing allogeneic or autologous bone marrow or peripheral blood stem cell transplantation were treated empirically or for documented fungal infection with liposomal amphotericin-B in doses up to 10mg/kg bodyw eight for a duration up to 61 days. The therapy was excellent tolerated and clinical side effects occurred in only eight patients. The drug had to be withdrawn in one episode. A significant influence of liposomal amphotericin -R on laboratory parameters was not observed. Creatinine increased under th erapy from a median base point of 1,0 (0,2-3,5) mg/dl to the upper normal v alue of 1,4 (0,4-4,2) mg/dl. Heavy increases of creatinine as well as of bi lirubin, OT and PT were mostly associated with GvHD or regimen related toxi city. Considering the highrisk state of the patients the overall response r ate was favourable with 62,9%. However, despite administration of liposomal amphotericin-B culture-proven mycoses were associated with a high morbidit y (93,3%). Only one of fourteen patients was cured from Candida lambica sep ticaemia. We conclude that the antimycotic therapy with liposomal amphoteri cin-B has a low incidence of side effects. This should, considering the hig h mortality of fungal infections in BMT receipients, encourage investigator s to perform dose escalating studies against the conventional formulation.