Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Department of Respiration, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Front Cell Infect Microbiol. 2023 May 17;13:1147624. doi: 10.3389/fcimb.2023.1147624. eCollection 2023.
Mucormycosis has emerged as an increasingly important cause of morbidity and mortality in immunocompromised patients, but the effective drugs for the treatment are limited. Hence, the study aimed to summarize the characteristics of mucormycosis in patients with hematological malignancies, and investigate the efficacy and safety of Amphotericin B Colloidal Dispersion (ABCD) in treating mucormycosis.
In this study, patients with mucormycosis complicated by hematological malignancies who received ABCD at the First Affiliated Hospital of Zhengzhou University from April 2021 to May 2022 were retrospectively enrolled. The clinical data of the enrolled patients were collected, and then, the drug response at 2 weeks, 4 weeks, and the end of treatment; the survival rate at 4, 8, and 12 weeks; and the laboratory-related indicators and adverse events (AEs) associated with ABCD were evaluated.
In total, 9 patients with mucormycosis complicated by hematological malignancies were enrolled. The main symptoms were fever, cough, and chest pain. In addition, reversed halo signs (RHS) were found on chest CTs. The responses to ABCD at 2 weeks, 4 weeks, and the end of treatment were 100% (9/9), 77.8% (7/9), and 77.8% (7/9), respectively. The survival rates of the patients at 4, 8, and 12 weeks were 77.8% (7/9), 66.7% (6/9), and 66.7% (6/9), respectively. Among laboratory-related indicators, white blood cell (WBC) counts were significantly increased from baseline after 1 and 2 weeks of ABCD treatment (<0.05), whereas neutrophil counts were only increased significantly from baseline at 2 weeks post-treatment (<0.05). The most common AEs were infusion-related AEs manifesting as fever, chills, and pruritus. Moreover, none of the patients suffered from renal injury once again.
ABCD is a promising treatment strategy for patients with mucormycosis complicated by hematologic malignancies, showing remarkable efficacy and safety.
毛霉菌病已成为免疫功能低下患者发病率和死亡率日益增加的重要原因，但治疗有效的药物有限。因此，本研究旨在总结血液病患者毛霉菌病的特征，并探讨两性霉素 B 胶体分散体（ABCD）治疗毛霉菌病的疗效和安全性。
本研究回顾性纳入 2021 年 4 月至 2022 年 5 月在郑州大学第一附属医院接受 ABCD 治疗的伴有血液恶性肿瘤的毛霉菌病患者。收集入组患者的临床资料，评估治疗 2 周、4 周及治疗结束时的药物反应；4、8、12 周时的生存率；以及与 ABCD 相关的实验室相关指标和不良事件（AE）。
共纳入 9 例伴有血液恶性肿瘤的毛霉菌病患者。主要症状为发热、咳嗽和胸痛。此外，胸部 CT 发现反转晕征（RHS）。ABCD 治疗 2 周、4 周及治疗结束时的反应率分别为 100%（9/9）、77.8%（7/9）和 77.8%（7/9）。患者在 4、8 和 12 周的生存率分别为 77.8%（7/9）、66.7%（6/9）和 66.7%（6/9）。在实验室相关指标中，ABCD 治疗 1 周和 2 周后，白细胞（WBC）计数明显高于基线（<0.05），而中性粒细胞计数仅在治疗后 2 周时明显高于基线（<0.05）。最常见的 AE 是输液相关 AE，表现为发热、寒战和瘙痒。此外，没有患者再次出现肾损伤。
ABCD 是血液恶性肿瘤合并毛霉菌病患者有前途的治疗策略，具有显著的疗效和安全性。
