TY - JOUR
T1 - Treating pediatric cutaneous Leishmania tropica with systemic liposomal amphotericin B
T2 - A retrospective, single-center study
AU - Noyman, Yehonatan
AU - Levi, Assi
AU - Ben Amitai, Dan
AU - Reiss-Huss, Shiran
AU - Sabbah, Fareed
AU - Hodak, Emmilia
AU - Mimouni, Tomer
AU - Friedland, Rivka
N1 - Publisher Copyright:
© 2021 Wiley Periodicals LLC.
PY - 2022/1
Y1 - 2022/1
N2 - Leishmania tropica (L. tropica) cutaneous leishmaniasis (CL) is associated with high morbidity and low response rate to therapy, especially in pediatric patients. Intravenous (IV) liposomal amphotericin B (LAmB) has been used off-label as a treatment for L. tropica CL for many years. However, data regarding its efficacy and safety in children is lacking. In order to evaluate the efficacy and safety of IV LAmB for treating pediatric patients with L. tropica, we retrospectively reviewed electronic medical records of 24 children who were diagnosed with L. tropica CL and treated with IV LAmB during 2014–2020, at a tertiary medical center in Israel. Fourteen (58%) completed the treatment protocol and 10 (42%) experienced an infusion-related adverse event (IRAE) leading to treatment termination. Complete response was noted in 6/14 (43%) patients, while 8/14 (57%) failed to respond. Lower response rate was noted in lesions involving the mid-facial area. The relatively low response rate is speculated to result from a low dose of LAmB, short follow-up period, and difficult to treat anatomic locations. The observation of a lower response rate for mid-facial lesions should be validated in larger cohorts. The highrisk of IRAE should be considered in physician decisions regarding this treatment.
AB - Leishmania tropica (L. tropica) cutaneous leishmaniasis (CL) is associated with high morbidity and low response rate to therapy, especially in pediatric patients. Intravenous (IV) liposomal amphotericin B (LAmB) has been used off-label as a treatment for L. tropica CL for many years. However, data regarding its efficacy and safety in children is lacking. In order to evaluate the efficacy and safety of IV LAmB for treating pediatric patients with L. tropica, we retrospectively reviewed electronic medical records of 24 children who were diagnosed with L. tropica CL and treated with IV LAmB during 2014–2020, at a tertiary medical center in Israel. Fourteen (58%) completed the treatment protocol and 10 (42%) experienced an infusion-related adverse event (IRAE) leading to treatment termination. Complete response was noted in 6/14 (43%) patients, while 8/14 (57%) failed to respond. Lower response rate was noted in lesions involving the mid-facial area. The relatively low response rate is speculated to result from a low dose of LAmB, short follow-up period, and difficult to treat anatomic locations. The observation of a lower response rate for mid-facial lesions should be validated in larger cohorts. The highrisk of IRAE should be considered in physician decisions regarding this treatment.
UR - http://www.scopus.com/inward/record.url?scp=85120317139&partnerID=8YFLogxK
U2 - 10.1111/dth.15185
DO - 10.1111/dth.15185
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C2 - 34716724
AN - SCOPUS:85120317139
SN - 1396-0296
VL - 35
JO - Dermatologic Therapy
JF - Dermatologic Therapy
IS - 1
M1 - e15185
ER -