A Strategic Study to Determine the Optimal Moment to Initiate Systemic Antifungal Therapy With Ambisome in Granulocytopenic Cancer Patients With Unexplained Fever Refractory to Empirical Antibacterials
liposomal amphotericin B
Linfadenopatía+107
+ Enfermedades Urogenitales
+ Enfermedades Genitales
Estudio de Cuidados de Apoyo
Resumen
Fecha de inicio: 1 de junio de 1999
Fecha en la que se inscribió al primer participante.OBJECTIVES: Compare the efficacy and side effects of amphotericin B-liposomal formulation initiated 72-84 hours vs 144-156 hours after onset of a febrile episode in cancer patients with granulocytopenia and persistent unexplained fever refractory to antibacterials. OUTLINE: This is a randomized, multicenter study. Patients are stratified according to antifungal prophylaxis (yes vs no) and type of underlying condition. Patients are randomized to 1 of 2 treatment arms. Arm I: Patients receive amphotericin B-liposomal formulation IV over 1 hour on day 3 of febrile neutropenia. Arm II: Patients receive amphotericin B-liposomal formulation IV over 1 hour on day 6 of febrile neutropenia. Treatment continues until signs and symptoms of the fungal infection appear or febrile neutropenia has resolved. Persistently neutropenic patients receive treatment for at least 10 days or until another cause of infection is determined. Patients are followed weekly for 3 weeks. PROJECTED ACCRUAL: A total of 450 patients will be accrued for this study.
Protocolo
Esta sección proporciona detalles del plan del estudio, incluyendo cómo está diseñado y qué se está evaluando.Se reclutarán 115 pacientes
Número total de participantes que el ensayo clínico espera reclutar.Estudio de Cuidados de Apoyo
Elegibilidad
Los investigadores buscan pacientes que cumplan ciertos criterios, conocidos como criterios de elegibilidad: estado general de salud o tratamientos previos.Cualquier sexo
Sexo biológico de los participantes elegibles para inscribirse.Voluntarios sanos no permitidos
Indica si personas sanas, sin la condición que se estudia, pueden participar.Condiciones
Patología
Criterios
DISEASE CHARACTERISTICS: Hematologic malignancy or solid tumor Must be undergoing remission induction and/or consolidation therapy for hematologic malignancy only OR Must be undergoing allogeneic or autologous bone marrow transplantation Granulocyte count less than 500/mm^3 and profound granulocytopenia expected to last for greater than 5 days Fever (greater than 38.5 degrees C) refractory for greater than 72 hours and less than 84 hours to broad spectrum antimicrobials, after exclusion of current bacterial, fungal, viral, parasitic, and mycobacterial infections Peripheral blood cultures and central venous catheter cultures negative for infections No microbiological documentation of a bacterial infection (e.g., abscess at catheter site) No invasive fungal infection No probable noninfectious cause of fever PATIENT CHARACTERISTICS: Age: Not specified Performance status: Karnofsky 40-100% OR WHO 0-2 Life expectancy: Not specified Hematopoietic: See Disease Characteristics Hepatic: Not specified Renal: Not specified Other: No prior anaphylactic reaction to amphotericin B No psychological, familial, sociological, or geographical conditions that would prevent compliance Not pregnant or nursing Normal chest X-ray or normal high resolution CT scan of the lungs PRIOR CONCURRENT THERAPY: Biologic therapy: See Disease Characteristics Chemotherapy: See Disease Characteristics Endocrine therapy: Not specified Radiotherapy: Not specified Surgery: Not specified Other: No concurrent active systemic antifungal agents or antifungal prophylaxis (e.g., azoles or polyenes) No prior IV amphotericin B during same neutropenic episode No change in antibacterial regimen within 48 hours prior to study
Centros del Estudio
Estos son los hospitales, clínicas o centros de investigación donde se lleva a cabo el estudio. Puedes encontrar la ubicación más cercana a ti y su estado de reclutamiento.Este estudio tiene 24 ubicaciones
Institut Jules Bordet
Brussels, BelgiumHopital Universitaire Erasme
Brussels, BelgiumU.Z. Gasthuisberg
Leuven, Belgium