Empiric amphotericin B therapy in patients with acute leukemia

Invasive fungal infections remain a considerable problem in the management of patients with acute leukemia. This review discusses and provides guidelines for empiric treatment in such circumstances, with emphasis on the use of amphotericin B. The topics covered include the risk factors associated with the development of fungal infections; the difficulties of diagnosing a fungal infection; the empiric use of amphotericin B (with a review of clinical trials and dosing guidelines); and the role of other therapeutic measures in oral prophylaxis and treatment. Although other organisms have been shown to cause fungal infections in patients with acute leukemia, only Candida and Aspergillus species are discussed formally in terms of diagnosis and therapy.