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.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Rui Ma
- Telefonnummer: +86 18834948122
- E-mail: marui_pku_ed@163.com
Studiesteder
-
-
Beijing Municipality
-
Beijing, Beijing Municipality, Kina
- Peking University People's Hospital
-
Kontakt:
- Rui Ma
- Telefonnummer: +86 18834948122
- E-mail: marui_pku_ed@163.com
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
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.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: 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.
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Overall Response Rate of Antifungal Therapy at 6 Weeks (42 Days)
Tidsramme: 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
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Overall Survival Rate at 6 Weeks
Tidsramme: 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
Tidsramme: 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
Tidsramme: From enrollment to the end of 6-week treatment
|
Change from baseline in serum galactomannan test value.
Unit of measure: ug/L.
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From enrollment to the end of 6-week treatment
|
|
Microbiological clearance
Tidsramme: 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).
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From enrollment to the end of 6-week treatment
|
|
Change in chest CT findings
Tidsramme: 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)
Tidsramme: 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
Tidsramme: During treatment period (up to 6 weeks).
|
Proportion of participants who permanently stop amphotericin B because of any AE.
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During treatment period (up to 6 weeks).
|
|
Change in serum alanine aminotransferase (ALT)
Tidsramme: 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)
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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)
Tidsramme: 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
Tidsramme: 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).
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- PKUPH20260411
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