Serum galactomannan assay for diagnosis of probable invasive Aspergillosis in acute leukemia and hematopoietic stem cell transplantation
Background: Invasive aspergillosis (IA) is a leading cause of mortality in acute leukemia and hematopoietic stem cell transplantation (HSCT). Aims: To determine the yield of galactomannan (GM) assay for the diagnosis of probable IA, its temporal relationship with the computed tomography (CT) scans a...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Medical and Scientific Publishers Pvt. Ltd.
2013-01-01
|
| Series: | Indian Journal of Medical and Paediatric Oncology |
| Subjects: | |
| Online Access: | http://www.ijmpo.org/article.asp?issn=0971-5851;year=2013;volume=34;issue=2;spage=74;epage=79;aulast=Ghosh |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849724488467349504 |
|---|---|
| author | Indranil Ghosh Vinod Raina Lalit Kumar Atul Sharma Sameer Bakhshi Sobuhi Iqbal |
| author_facet | Indranil Ghosh Vinod Raina Lalit Kumar Atul Sharma Sameer Bakhshi Sobuhi Iqbal |
| author_sort | Indranil Ghosh |
| collection | DOAJ |
| description | Background: Invasive aspergillosis (IA) is a leading cause of mortality in acute leukemia and hematopoietic stem cell transplantation (HSCT). Aims: To determine the yield of galactomannan (GM) assay for the diagnosis of probable IA, its temporal relationship with the computed tomography (CT) scans and correlation with mortality in AL and HSCT. Patients and Methods: Consecutive neutropenic episodes (n=150) among inpatients aged ≥15 years with AL or recipients of HSCT were prospectively evaluated over 1 years. All patients underwent weekly serum GM assay and optical density index >0.5 for ≥2 samples was defined as positive. IA was diagnosed according to EORTC 2008 guidelines. Results: Of the 150 episodes enrolled, 43 (28.7%) were diagnosed with IA: possible 25 (16.7%), probable 17 (11.3%) and proven 1 (0.7%). The yield of GM assay in diagnosing probable IA was 17/42 (40.5%). In 88.2% of probable IA episodes, GM was positive before high-resolution CT at a median of 10 days (range 1-16). In the episodes with ≥2 samples tested, fatality was higher in those ≥2 values positive for GM, compared to the rest (31% vs. 13.2%, odd ratio 2.96, 95% CI 1.09-8.00; P=0.04). Conclusions: In AL and HSCT, GM assay could identify patients with probable IA earlier than CT chest and also predicted a higher risk of death. |
| format | Article |
| id | doaj-art-7f98d4e55a9942838420f0a64c0e2e68 |
| institution | DOAJ |
| issn | 0971-5851 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Indian Journal of Medical and Paediatric Oncology |
| spelling | doaj-art-7f98d4e55a9942838420f0a64c0e2e682025-08-20T03:10:42ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Medical and Paediatric Oncology0971-58512013-01-01342747910.4103/0971-5851.116181Serum galactomannan assay for diagnosis of probable invasive Aspergillosis in acute leukemia and hematopoietic stem cell transplantationIndranil GhoshVinod RainaLalit KumarAtul SharmaSameer BakhshiSobuhi IqbalBackground: Invasive aspergillosis (IA) is a leading cause of mortality in acute leukemia and hematopoietic stem cell transplantation (HSCT). Aims: To determine the yield of galactomannan (GM) assay for the diagnosis of probable IA, its temporal relationship with the computed tomography (CT) scans and correlation with mortality in AL and HSCT. Patients and Methods: Consecutive neutropenic episodes (n=150) among inpatients aged ≥15 years with AL or recipients of HSCT were prospectively evaluated over 1 years. All patients underwent weekly serum GM assay and optical density index >0.5 for ≥2 samples was defined as positive. IA was diagnosed according to EORTC 2008 guidelines. Results: Of the 150 episodes enrolled, 43 (28.7%) were diagnosed with IA: possible 25 (16.7%), probable 17 (11.3%) and proven 1 (0.7%). The yield of GM assay in diagnosing probable IA was 17/42 (40.5%). In 88.2% of probable IA episodes, GM was positive before high-resolution CT at a median of 10 days (range 1-16). In the episodes with ≥2 samples tested, fatality was higher in those ≥2 values positive for GM, compared to the rest (31% vs. 13.2%, odd ratio 2.96, 95% CI 1.09-8.00; P=0.04). Conclusions: In AL and HSCT, GM assay could identify patients with probable IA earlier than CT chest and also predicted a higher risk of death.http://www.ijmpo.org/article.asp?issn=0971-5851;year=2013;volume=34;issue=2;spage=74;epage=79;aulast=GhoshAcute leukemiacomputed tomographygalactomannan assayhematopoietic stem cell transplantationinvasive Aspergillosis |
| spellingShingle | Indranil Ghosh Vinod Raina Lalit Kumar Atul Sharma Sameer Bakhshi Sobuhi Iqbal Serum galactomannan assay for diagnosis of probable invasive Aspergillosis in acute leukemia and hematopoietic stem cell transplantation Indian Journal of Medical and Paediatric Oncology Acute leukemia computed tomography galactomannan assay hematopoietic stem cell transplantation invasive Aspergillosis |
| title | Serum galactomannan assay for diagnosis of probable invasive Aspergillosis in acute leukemia and hematopoietic stem cell transplantation |
| title_full | Serum galactomannan assay for diagnosis of probable invasive Aspergillosis in acute leukemia and hematopoietic stem cell transplantation |
| title_fullStr | Serum galactomannan assay for diagnosis of probable invasive Aspergillosis in acute leukemia and hematopoietic stem cell transplantation |
| title_full_unstemmed | Serum galactomannan assay for diagnosis of probable invasive Aspergillosis in acute leukemia and hematopoietic stem cell transplantation |
| title_short | Serum galactomannan assay for diagnosis of probable invasive Aspergillosis in acute leukemia and hematopoietic stem cell transplantation |
| title_sort | serum galactomannan assay for diagnosis of probable invasive aspergillosis in acute leukemia and hematopoietic stem cell transplantation |
| topic | Acute leukemia computed tomography galactomannan assay hematopoietic stem cell transplantation invasive Aspergillosis |
| url | http://www.ijmpo.org/article.asp?issn=0971-5851;year=2013;volume=34;issue=2;spage=74;epage=79;aulast=Ghosh |
| work_keys_str_mv | AT indranilghosh serumgalactomannanassayfordiagnosisofprobableinvasiveaspergillosisinacuteleukemiaandhematopoieticstemcelltransplantation AT vinodraina serumgalactomannanassayfordiagnosisofprobableinvasiveaspergillosisinacuteleukemiaandhematopoieticstemcelltransplantation AT lalitkumar serumgalactomannanassayfordiagnosisofprobableinvasiveaspergillosisinacuteleukemiaandhematopoieticstemcelltransplantation AT atulsharma serumgalactomannanassayfordiagnosisofprobableinvasiveaspergillosisinacuteleukemiaandhematopoieticstemcelltransplantation AT sameerbakhshi serumgalactomannanassayfordiagnosisofprobableinvasiveaspergillosisinacuteleukemiaandhematopoieticstemcelltransplantation AT sobuhiiqbal serumgalactomannanassayfordiagnosisofprobableinvasiveaspergillosisinacuteleukemiaandhematopoieticstemcelltransplantation |