Universität zu Köln

Cornely, Oliver A., Maertens, Johan, Bresnik, Mark, Ebrahimi, Ramin, Dellow, Emma, Herbrecht, Raoul ORCID: 0000-0002-9381-4876 and Donnelly, J. Peter (2011). Efficacy outcomes in a randomised trial of liposomal amphotericin B based on revised EORTC/MSG 2008 definitions of invasive mould disease. Mycoses, 54 (5). S. E449 - 7. HOBOKEN: WILEY. ISSN 1439-0507

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Abstract

In 2008, the European Organisation for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) published revised definitions for diagnosing invasive fungal disease. A previous prospective trial of liposomal amphotericin B for invasive mould disease (AmBiLoad) used modified EORTC/MSG 2002 criteria. We wished to re-evaluate the response and survival based on the revised definitions to compare the outcomes of early vs. late treatment. Patients who had received an allogeneic haematopoietic stem cell transplant or who were neutropaenic (absolute neutrophil count <500 mu l(-1) within 14 days of study entry) had been recruited on the basis of a halo or air crescent sign on chest computerised tomography. Originally classified as probable invasive mould disease, they were categorised as possible invasive mould disease using 2008 criteria. Patients had received liposomal amphotericin B at either 3 or 10 mg kg(-1) QD for 14 days, followed by 3 mg kg(-1) QD. Response at end of treatment and the 12-week survival were re-calculated according to 2008 definitions. Six-week survival was estimated by Kaplan-Meier analysis. Of 201 patients with invasive mould disease, 118 (59%) had a diagnosis based on halo signs (possible cases). Mycological evidence was present in 83 (41%) cases (probable/proven cases). Survival rates at 12 weeks for possible vs. probable/proven cases in the 3 mg kg(-1) QD group were 82% vs. 58% (P = 0.006), and 65% vs. 50% (P = 0.15) in the 10 mg kg(-1) QD group. At 6 weeks, rates were 87% vs. 69% in the 3 mg kg(-1) QD group (P = 0.009). and 75% vs. 61% in the 10 mg kg(-1) QD group (P = 0.01). Patients with possible invasive mould disease based on EORTC/MSG 2008 criteria had improved survival rates compared with those treated for probable/proven invasive mould disease. As possible invasive mould disease probably reflects an early-stage of disease, a better outcome might be expected when treatment with liposomal amphotericin B is started preemptively.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Maertens, Johan UNSPECIFIED UNSPECIFIED UNSPECIFIED Bresnik, Mark UNSPECIFIED UNSPECIFIED UNSPECIFIED Ebrahimi, Ramin UNSPECIFIED UNSPECIFIED UNSPECIFIED Dellow, Emma UNSPECIFIED UNSPECIFIED UNSPECIFIED Herbrecht, Raoul UNSPECIFIED orcid.org/0000-0002-9381-4876 UNSPECIFIED Donnelly, J. Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-489607
DOI:	10.1111/j.1439-0507.2010.01947.x
Journal or Publication Title:	Mycoses
Volume:	54
Number:	5
Page Range:	S. E449 - 7
Date:	2011
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1439-0507
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PULMONARY ASPERGILLOSIS; FUNGAL-INFECTIONS; TOMOGRAPHIC SCAN; PERSISTENT FEVER; THERAPY; PROPHYLAXIS; GALACTOMANNAN; ITRACONAZOLE; POSACONAZOLE; CASPOFUNGIN Multiple languages Dermatology; Mycology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48960