Hematological toxicities associated with amphotericin B formulations.

Even though amphotericin B is associated with considerable hematological toxicity, this subject has been poorly studied. This retrospective cohort study assessed the incidence and predictors of hematological toxicity in patients treated with different amphotericin B formulations: amphotericin B deoxycholate (d-AmB), liposomal amphotericin B (L-AmB) and amphotericin B lipid complex (ABLC). A total of 497 patients were included. Severe anemia was independently associated with human immunodeficiency virus (HIV) infection (odds ratio [OR] 1.79; 95% confidence interval [CI]: 1.03-3.06). L-AmB use was marginally associated with reduced risk for severe anemia (OR 0.61; CI: 0.32-1.11). Severe leukopenia was associated with ABLC use (OR 2.58; CI: 1.05-6.21) and hematological cancer (OR 4.61; CI: 2.07-10.38). Hematological cancer (OR 5.00; CI 2.79-8.97) was independently associated with risk of severe thrombocytopenia. In this study, significant hematological toxicity was associated with amphotericin B treatment, along with previous hematological disease and use of myelotoxic drugs. Close monitoring is required when managing patients receiving amphotericin B formulations.