AspergillusGalactomannan Detection in the Diagnosis of Invasive Aspergillosis in Cancer Patients

Abstract

Galactomannan ELISA seems less sensitive than previously described, and sensitivity can be further reduced by the presence of anti-Aspergillus antibodies. A new cutoff value for the ELISA of 0.700 is proposed for non-allo-HSCT adults.

Galactomannan detection in computerized tomography‐based broncho‐alveolar lavage fluid and serum in haematological patients at risk for invasive pulmonary aspergillosis

“…A very recent, large study in oncological patients also reported less favourable test characteristics of GM detection in serum (Herbrecht et al, 2002), i.e. a sensitivity of 32%, a specificity of 95%, a PPV of 58% and a NPV of 85%.…”

High rate of discordance between clinical and autopsy diagnoses in blood and marrow transplantation

“…Although invasive aspergillosis may now be detected by the serum galactomannan assay, 29 this test is limited by its restricted test characteristics; a false-positive rate as high as 14% has been reported. [29][30][31] In our study, even if all disagreements due to Aspergillus species were removed, 25 of the 30 PM disagreements would remain. Although a strategy for CMV surveillance of peripheral blood leukocytes with pre-emptive ganciclovir therapy has been in practice at our center since 1997, 32 CMV surveillance did not appear to affect the rates of disagreement before and after its introduction (Table 3).…”

ECIL recommendations for the use of biological markers for the diagnosis of invasive fungal diseases in leukemic patients and hematopoietic SCT recipients

“…5 Differences in performance of the EIA are probably due to differences in the pathogenesis of Aspergillus diseases in various host groups. [6][7][8][9] In neutropenic patients, angioinvasive aspergillosis occurs, which is associated with an invasion of blood vessels due to a poor immune response. In non-neutropenic patients, such as hematological patients after BM recovery or non-hematological patients treated with long-term corticosteroids and other immunosuppressive regimens, a significant local inflammation limiting the angio-invasive process occurs.…”