scholarly journals Pharmacoeconomic evaluation of voriconazole versus posaconazole for antifungal prophylaxis in acute myeloid leukaemia

2010 ◽  
Vol 65 (5) ◽  
pp. 1052-1061 ◽  
Author(s):  
D. Al-Badriyeh ◽  
M. Slavin ◽  
D. Liew ◽  
K. Thursky ◽  
M. Downey ◽  
...  
Keyword(s):  
Acute Myeloid Leukaemia ◽  
Myeloid Leukaemia ◽  
Pharmacoeconomic Evaluation ◽  
Antifungal Prophylaxis ◽  
Acute Myeloid

scholarly journals When azoles cannot be used: the clinical effectiveness of intermittent liposomal amphotericin prophylaxis in haematology patients

2021 ◽  
Author(s):  
R Batchelor ◽  
C Thomas ◽  
B J Gardiner ◽  
S J Lee ◽  
S Fleming ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Acute Myeloid Leukaemia ◽  
Myeloid Leukaemia ◽  
Liposomal Amphotericin ◽  
Kidney Injury ◽  
Antifungal Prophylaxis ◽  
High Rate ◽  
Clinical Scenarios ◽  
Haematology Patients ◽  
Acute Myeloid

Abstract Background Patients unable to take azoles are a neglected group lacking a standardized approach to antifungal prophylaxis. We evaluated the effectiveness and safety of intermittent liposomal amphotericin (L-AMB) prophylaxis in a heterogenous group of haematology patients. Methods A retrospective cohort of all haematology patients who received a course of intravenous L-AMB defined as 1mg/kg thrice weekly, from 1 July 2013-30 June 2018 were identified from pharmacy records. Outcomes included breakthrough-invasive fungal disease (BIFD), reasons for premature discontinuation and acute kidney injury. Results There were 198 patients who received 273 courses of L-AMB prophylaxis. Using a conservative definition, the BIFD rate was 9.6% (n=19/198) occurring either during L-AMB prophylaxis or up to 7 days from cessation in patients who received a course. Probable/proven-BIFD occurred in 13 patients (6.6%, 13/198), including molds in 54% (n=7) and non-albicans Candidaemia in 46% (n=6). Cumulative incidence of BIFD was highest in patients with acute myeloid leukaemia (6.8%) followed by acute lymphoblastic leukaemia (2.7%) and allogeneic stem cell transplantation (2.5%). The most common indication for L-AMB was chemotherapy or anticancer drug-azole interactions (75% of courses) dominated by vincristine or acute myeloid leukaemia clinical trials, followed by gut absorption concerns (13%) and liver function abnormalities (8.8%). Acute kidney injury using a modified international definition, complicated 27% of courses but was not clinically significant accounting for only 3.3% (9/273) of discontinuations. Conclusions Our findings demonstrate a high rate of BIFD among patients receiving L-AMB prophylaxis. Pragmatic trials will help find the optimal regimen of L-AMB prophylaxis for the many clinical scenarios where azoles are unsuitable, especially as targeted anticancer drugs increase in use.

The acute myeloid leukaemia market

2019 ◽  
Vol 19 (4) ◽  
pp. 233-234
Author(s):  
Jorrit Schaefer ◽  
Sorcha Cassidy ◽  
Rachel M. Webster
Keyword(s):  
Acute Myeloid Leukaemia ◽  
Myeloid Leukaemia ◽  
Acute Myeloid

Radioimmunotherapy for treatment of acute myeloid leukaemia and myelodysplastic syndrome

2005 ◽  
Vol 44 (03) ◽  
pp. 107-117
Author(s):  
R. G. Meyer ◽  
W. Herr ◽  
A. Helisch ◽  
P. Bartenstein ◽  
I. Buchmann
Keyword(s):  
Acute Myeloid Leukaemia ◽  
Myeloid Leukaemia ◽  
Primary Tumour ◽  
The Other ◽  
Haematopoietic Stem Cell ◽  
Other Hand ◽  
Primary Reduction ◽  
The One ◽  
Acute Myeloid

SummaryThe prognosis of patients with acute myeloid leukaemia (AML) has improved considerably by introduction of aggressive consolidation chemotherapy and haematopoietic stem cell transplantation (SCT). Nevertheless, only 20-30% of patients with AML achieve long-term diseasefree survival after SCT. The most common cause of treatment failure is relapse. Additionally, mortality rates are significantly increased by therapy-related causes such as toxicity of chemotherapy and complications of SCT. Including radioimmunotherapies in the treatment of AML and myelodyplastic syndrome (MDS) allows for the achievement of a pronounced antileukaemic effect for the reduction of relapse rates on the one hand. On the other hand, no increase of acute toxicity and later complications should be induced. These effects are important for the primary reduction of tumour cells as well as for the myeloablative conditioning before SCT.This paper provides a systematic and critical review of the currently used radionuclides and immunoconjugates for the treatment of AML and MDS and summarizes the literature on primary tumour cell reductive radioimmunotherapies on the one hand and conditioning radioimmunotherapies before SCT on the other hand.

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