Liposomal amphotericin B (L-AMB) is widely used for empirical or preemptive therapy and treatment of invasive fungal infection after cord blood transplantation (CBT). We retrospectively examined the efficacy and safety of low-dose L-AMB in 48 adult patients of CBT from between 2006 and 2017 in our institute. Among the entire cohort, 42 (88%) patients received L-AMB as an empirical or preemptive therapy. The median daily dose of L-AMB and the median cumulative dose of L-AMB were 1.20 mg/kg/day (range, 0.62–2.60 mg/kg/day) and 30.6 mg/kg (range, 0.7–241.5 mg/kg), respectively. The median duration of L-AMB administration was 21.5 days (range, 1–313 days). Documented breakthrough fungal infection occurred in 1 patient during L-AMB treatment, and 43 (90%) patients survived for at least 7 days after the end of L-AMB treatment. Grade 3 or higher hypokalemia and hepatotoxicity were frequently observed during L-AMB treatment. However, no patients developed an increase in serum creatinine of grade 3 or higher. In the univariate analysis using a logistic regression model, a duration of L-AMB treatment of more than 21 days and a cumulative dose of L-AMB more than 30 mg/kg were significantly associated with nephrotoxicity and grade 3 hypokalemia. These data suggest that low-dose L-AMB may be safe and effective in adult patients undergoing CBT.
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