{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T09:39:30Z","timestamp":1784194770946,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2003,1,3]],"date-time":"2003-01-03T00:00:00Z","timestamp":1041552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2003,1,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Fungal infections are a major cause of morbidity and mortality in patients undergoing induction chemotherapy for acute myelogenous leukemia (AML) and myelodysplastic syndrome (MDS). The authors evaluated the efficacy and toxicity of liposomal amphotericin B (L\u2010AmB) compared with a combination of fluconazole plus itraconazole (F+I) as prophylaxis in this setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Patients with newly diagnosed AML or high\u2010risk MDS who were undergoing initial induction chemotherapy were randomized to receive either F+I (fluconazole 200 mg orally every 12 hours plus itraconazole tablets 200 mg orally every 12 hours) or L\u2010AmB (3 mg\/kg intravenously 3 times per week) in this prospective, open\u2010label study.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Seventy\u2010two L\u2010AmB\u2010treated patients and 67 F+I\u2010treated patients were enrolled in the study. Of these, 47% of patients completed antifungal prophylaxis without a change in therapy for proven or suspected fungal infection. Three patients in each arm developed a proven fungal infection. Twenty\u2010three percent of the L\u2010AmB\u2010treated patients and 24% of the F+I\u2010treated patients were changed to alternative antifungal therapy because of persistent fever (<jats:italic>P<\/jats:italic> value not significant). Nine percent of the L\u2010AmB\u2010treated patients developed pneumonia of unknown etiology compared with 16% of the F+I\u2010treated patients (<jats:italic>P<\/jats:italic> value not significant). Increases in serum creatinine levels to &gt; 2 mg\/dL (20% for the L\u2010AmB arm vs. 6% for the F+I arm; <jats:italic>P<\/jats:italic> = 0.012) and increases in serum bilirubin levels to &gt; 2 mg\/dL (43% vs. 22%, respectively; <jats:italic>P<\/jats:italic> = 0.021) were more common with L\u2010AmB. Infusion\u2010related reactions were noted in five L\u2010AmB\u2010treated patients. Responses to chemotherapy and induction mortality rates were similar for the two arms.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>L\u2010AmB and F+I appear similar in their efficacy as antifungal prophylaxis during induction chemotherapy for patients with AML and MDS. L\u2010AmB was associated with higher rates of increased serum bilirubin and creatinine levels. Cancer 2003;97:450\u20136. \u00a9 2003 American Cancer Society.<\/jats:p><jats:p>DOI 10.1002\/cncr.11094<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.11094","type":"journal-article","created":{"date-parts":[[2003,2,19]],"date-time":"2003-02-19T19:30:30Z","timestamp":1045683030000},"page":"450-456","source":"Crossref","is-referenced-by-count":69,"title":["Liposomal amphotericin B versus the combination of fluconazole and itraconazole as prophylaxis for invasive fungal infections during induction"],"prefix":"10.1002","volume":"97","author":[{"given":"Gloria N.","family":"Mattiuzzi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elihu","family":"Estey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issam","family":"Raad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Giles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Cortes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Kontoyiannis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Koller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Munsell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miloslav","family":"Beran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hagop","family":"Kantarjian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2003,1,3]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/171.6.1545"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199203263261301"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1086\/515129"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1999.01465.x"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02026116"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-118-7-199304010-00003"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19940415)73:8<2099::AID-CNCR2820730814>3.0.CO;2-N"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1086\/515128"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/172.4.1035"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-120-11-199406010-00003"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20001001)89:7<1611::AID-CNCR27>3.0.CO;2-B"},{"key":"e_1_2_5_13_2","first-page":"321","article-title":"Fungal 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