Amphotericin B for Breakthrough Fungal Infections After Triazole Prophylaxis in Hematological Patients
A Multicenter, Prospective, Observational Study to Evaluate the Efficacy and Safety of Amphotericin B in the Treatment of Breakthrough Invasive Fungal Disease in Hematological Patients Receiving Triazole Prophylaxis
The goal of this clinical trial is to learn if amphotericin B works to treat breakthrough invasive fungal disease (IFD) in patients with hematological diseases who have received azole-based prophylaxis. It will also learn about the safety of amphotericin B in this population.
The main questions it aims to answer are:
- What is the overall response rate (complete remission + partial remission) of amphotericin B in treating breakthrough IFD after azole prophylaxis?
- What medical problems do participants have when taking amphotericin B?
- What is the 6-week (42-day) overall survival rate after starting treatment?
This is a single-arm, prospective study. Participants will:
- Receive intravenous liposomal amphotericin B (3-5 mg/kg daily) for 4-6 weeks.
- Undergo weekly clinical and laboratory assessments, including serum G/GM tests, microbiology tests, and imaging (CT) at 2, 4, and 6 weeks.
- Have safety monitoring including liver and kidney function, electrolytes, and ECG.
- Be followed for treatment response and survival.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Rui Ma
- Phone Number: +86 18834948122
- Email: marui_pku_ed@163.com
Study Locations
-
-
Beijing Municipality
-
Beijing, Beijing Municipality, China
- Peking University People's Hospital
-
Contact:
- Rui Ma
- Phone Number: +86 18834948122
- Email: marui_pku_ed@163.com
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥ 18 years old.
- Diagnosed with hematological diseases and receiving triazole prophylaxis.
- Confirmed or suspected breakthrough invasive fungal disease (IFD) according to EORTC/MSG 2020 criteria.
- Able to understand and sign the informed consent form voluntarily.
Exclusion Criteria:
- Severe liver or renal dysfunction (ALT/AST > 3×ULN, Cr > 2×ULN).
- Known allergy to amphotericin B or any component of the study drug.
- Pregnant or lactating women.
- Severe underlying diseases with expected survival < 3 months.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Amphotericin B Treatment
|
Amphotericin B is a polyene antifungal drug used to treat breakthrough fungal infections.
The dosage and duration will be determined based on pathogen results and clinical guidelines.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Overall Response Rate of Antifungal Therapy at 6 Weeks (42 Days)
Time Frame: 6 weeks (42 days) after treatment initiation
|
The overall response rate will be assessed at 6 weeks (42 days) after the initiation of amphotericin B treatment, evaluated according to the EORTC/MSG 2020 criteria for invasive fungal disease, including complete response, partial response, stable disease, and progressive disease.
|
6 weeks (42 days) after treatment initiation
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Overall Survival Rate at 6 Weeks
Time Frame: 6 weeks (42 days) after treatment initiation
|
Proportion of participants alive at 6 weeks (42 days) after initiation of amphotericin B therapy.
|
6 weeks (42 days) after treatment initiation
|
|
Change in serum G test level
Time Frame: From enrollment to the end of 6-week treatment
|
Change from baseline in serum (1,3)-β-D-glucan level.
Unit of measure: pg/mL.
|
From enrollment to the end of 6-week treatment
|
|
Change in serum GM test level
Time Frame: From enrollment to the end of 6-week treatment
|
Change from baseline in serum galactomannan test value.
Unit of measure: ug/L.
|
From enrollment to the end of 6-week treatment
|
|
Microbiological clearance
Time Frame: From enrollment to the end of 6-week treatment
|
Proportion of participants with negative conversion of baseline positive microbiological evidence (e.g., blood culture, sputum culture, mNGS, or site smear/culture).
|
From enrollment to the end of 6-week treatment
|
|
Change in chest CT findings
Time Frame: Baseline to 6 weeks after treatment initiation
|
Change from baseline in chest CT lesion characteristics (e.g., reduction in size, new lesions, complete resolution).
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Baseline to 6 weeks after treatment initiation
|
|
Proportion of participants with treatment-emergent adverse events (AEs)
Time Frame: From first dose to 30 days after last dose.
|
Proportion of participants experiencing any AE, graded according to WHO toxicity criteria (grade 3 or higher AEs leading to drug discontinuation).
|
From first dose to 30 days after last dose.
|
|
Proportion of participants discontinuing amphotericin B due to adverse events
Time Frame: During treatment period (up to 6 weeks).
|
Proportion of participants who permanently stop amphotericin B because of any AE.
|
During treatment period (up to 6 weeks).
|
|
Change in serum alanine aminotransferase (ALT)
Time Frame: Baseline to end of treatment up to 6 weeks (twice weekly).
|
Change from baseline in ALT level.
Unit of measure: U/L.
|
Baseline to end of treatment up to 6 weeks (twice weekly).
|
|
Change in serum aspartate aminotransferase (AST)
Time Frame: Baseline to end of treatment up to 6 weeks (twice weekly).
|
Change from baseline in AST level.
Unit of measure: U/L.
|
Baseline to end of treatment up to 6 weeks (twice weekly).
|
|
Change in serum total bilirubin
Time Frame: Baseline to end of treatment up to 6 weeks (twice weekly).
|
Change from baseline in total bilirubin level.
Unit of measure: μmol/L.
|
Baseline to end of treatment up to 6 weeks (twice weekly).
|
|
Change in serum creatinine
Time Frame: Baseline to end of treatment up to 6 weeks (twice weekly).
|
Description: Change from baseline in serum creatinine level.
Unit of measure: μmol/L.
|
Baseline to end of treatment up to 6 weeks (twice weekly).
|
|
Change in serum electrolyte levels (potassium, sodium, calcium, magnesium)
Time Frame: Baseline to end of treatment up to 6 weeks (twice weekly).
|
Change from baseline in serum levels of potassium, sodium, calcium, and magnesium.
Each electrolyte will be reported separately as absolute change (mmol/L) from baseline.
|
Baseline to end of treatment up to 6 weeks (twice weekly).
|
|
Change in electrocardiogram (ECG) findings
Time Frame: Baseline to end of treatment up to 6 weeks (weekly).
|
Change from baseline in ECG parameters (e.g., QTc interval).
|
Baseline to end of treatment up to 6 weeks (weekly).
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- PKUPH20260411
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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