Abstract: Objective To evaluate the efficacy and safety of 3-day rapid dose escalation treatment of amphotericin B(AmB) in childhood acute leukemia(AL) patients with invasive fungal disease(IFD). Methods Data on 108 AL patients with IFD during March 2009 to December 2018 were collected. Those assigned to standard group (n=50) received standard treatment for 5 days. New Group (n=58) received rapid dose-escalation for 3 days, The rate of adverse events and overall success rate in 4 weeks after initiation of AmB therapy were documented and retrospectively analyzed. Results We found the overall success rate was differed significantly between patients with proven and probable fungal infections in two group and the incidence of adverse events was similar between all patients (54.5% vs. 80.5%,P=0.021). Conclusions The 3-day schedule for drug administration of AMB presented a more effective, with less toxicity than the standard approach to treatmentfor childhood acute leukemia patients with IFD. There is nosignificant difference in the rate of AES between the 3-day escalation strategy and the 6-day escalation strategy. So we concluded that three-day dose escalation was better than standard treatment.

Key words: amphotericin B, rapid dose escalation, invasive fungal disease, acute leukemia, pediatric