[Value of Aspergillus galactomannan antigen detection in the diagnosis and follow-up of invasive aspergillosis in hematological patients].

Abstract

Serum galactomannan detection is considered to be a useful test for early diagnosis and follow-up of invasive aspergillosis. From February to September 2002, adult patients hospitalized in our Hematology Unit for receiving intensive chemotherapy and/or hematopoietic stem cell transplant were prospectively studied. We analyzed a total of 760 samples obtained from 100 patients. Eleven patients (11%) having a positive result (OD index >1.5 ng/ml) in two consecutive Platelia Aspergillus tests were considered galactomannan-positive cases. On the other hand, 12 patients (12%) were diagnosed of proven or probable invasive aspergillosis. Sensitivity (66.6%), specificity (95.5%), positive predictive value (72.7%) and negative predictive value (96.7%) were comparable to those of larger series. Galactomannan positivity allowed also to anticipate invasive aspergillosis diagnosis (from two to 17 days before radiographic findings and from two to 15 days before mycological culture). Moreover, kinetics of antigenemia could be useful for assessing therapeutic response. Once accepted galactomannan test as a diagnostic criterium for invasive aspergillosis knowing potential causes of false positive results is of paramount importance.

• Authors: Isidro Jarque, Rafael Andreu, Miguel Salavert, Dolores Gómez, Javier Pemán, Miguel Gobernado, Miguel Angel Sanz
• Journal: Revista iberoamericana de micologia (Rev Iberoam Micol) Vol. 20 Issue 3 Pg. 116-8 (Sep 2003) ISSN: 1130-1406 [Print] Spain
• Vernacular Title: Valor de la detección del antígeno galactomanano de Aspergillus en el diagnóstico y seguimiento de la aspergilosis invasora en pacientes hematologícos.
• PMID: 15456368 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Antigens, Fungal
• Biomarkers
• Mannans
• galactomannan
• Galactose

Topics

• Adult
• Aged
• Antigens, Fungal (blood)
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Aspergillosis (blood, diagnosis, drug therapy, microbiology)
• Aspergillosis, Allergic Bronchopulmonary (blood, diagnosis, drug therapy, etiology)
• Aspergillus (immunology, isolation & purification)
• Biomarkers
• Combined Modality Therapy
• Enzyme-Linked Immunosorbent Assay
• Female
• Follow-Up Studies
• Fungemia (diagnosis, drug therapy, etiology)
• Galactose (analogs & derivatives)
• Hematologic Neoplasms (complications, drug therapy, therapy)
• Hematopoietic Stem Cell Transplantation
• Humans
• Immunocompromised Host
• Male
• Mannans (blood)
• Middle Aged
• Neutropenia (chemically induced, complications)
• Prospective Studies
• Sinusitis (blood, diagnosis, drug therapy, microbiology)