Autologous Bone Marrow Transplantation - Blog Science Connections

664 Amphotericin B for Neutropenie Fever
treated patients received WBC transfusions, which have been associated in
one series with an increased risk of pulmonary infiltrates (14). Pulmonary
toxicity, however, has been attributed to amphotericin B even in the absence
of WBC transfusion and may have contributed to the abnormal x-ray findings
in some of our patients (15).
Although the efficacy of empiric amphotericin B therapy in reducing the
risk of invasive fungal infections cannot be assessed directly in this study, our
experience is consistent with other published data that demonstrate frequent
clinical improvement after amphotericin B administration. Many of our
patients had intensive treatment for solid tumors, and thus belonged to a
group not usually at risk for invasive fungal infection during therapy. Toxicity,
moreover, was acceptable in our patients despite the use of rapid infusion
rates since only two patients required discontinuation of antifungal drug
owed to adverse reactions. Empiric amphotericin B therapy for unexplained
neutropenic fever is a safe and effective treatment for patients undergoing
intensive antitumor chemoradiotherapeutic regimens. We are conducting
additional studies of the role of surveillance fungal cultures or fungal
serologic studies to define more specific indications for amphotericin B
therapy in neutropenic patients.
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