Journal Article

Invasive Aspergillosis in Allogeneic Stem Cell Transplant Recipients: Increasing Antigenemia Is Associated with Progressive Disease

Boutboul François, Alberti Corinne, Leblanc Thierry, Sulahian Annie, Gluckman Eliane, Derouin Francis and Ribaud Patricia

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 34, issue 7, pages 939-943
Published in print April 2002 | ISSN: 1058-4838
Published online April 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/339324
Invasive Aspergillosis in Allogeneic Stem Cell Transplant Recipients: Increasing Antigenemia Is Associated with Progressive Disease

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The kinetics of serum Aspergillus galactomannan, as determined by enzyme-linked immunosorbent assay, was examined in 37 allogeneic stem cell transplant (SCT) recipients treated for invasive aspergillosis (IA). Fifty-eight periods of response (“response episodes”) were evaluated. There were 42 response episodes that were considered “treatment failures” and 16 that were considered “good” (that is, complete or partial) responses. At baseline (the first day of each new response episode), the patients who experienced treatment failure and those who had good responses did not differ significantly with regard to median galactomannan index (GMI) value. Thereafter, GMI values significantly increased in the treatment failure group, whereas no significant changes were observed in the good response group (P = .002). An increase in the GMI value of 1.0 over the baseline value during the first week of observation was predictive of treatment failure with a sensitivity of 44%, a specificity of 87%, and a positive predictive value of 94%. We conclude that serial determination of serum GMI values is a useful tool for assessing prognosis of IA in allogeneic SCT recipients during treatment.

Journal Article.  2705 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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