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

Rev Iberoam Micol. 2003 Sep;20(3):116-8.
[Article in Spanish]

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.

Publication types

  • Clinical Trial

MeSH terms

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

Substances

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