Serial assessment of pulmonary lesion volume by computed tomography allows survival prediction in invasive pulmonary aspergillosis

Vehreschild, J. J.; Heußel, Claus Peter; Groll, Andreas H.; Vehreschild, Maria J.G.T.; Silling, Gerda; Würthwein, Gudrun; Brecht, Marcus; Cornely, Oliver A.

doi:10.1007/s00330-016-4717-4

Cited by 34 publications

(29 citation statements)

References 26 publications

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“…This is a matter of concern as in Caillot et al study CT was stable at W2 . This might change with results from Vehreschild et al who evidence the importance to perform CT at D7 and D14 as lesion volume modifications between these two time points were associated with outcome . Other markers are therefore necessary to evaluate early treatment response.…”

Section: Discussionmentioning

confidence: 93%

Invasive pulmonary aspergillosis treatment duration in haematology patients in Europe: An EFISG, IDWP‐EBMT, EORTC‐IDG and SEIFEM survey

Seidel

Pagano

Styczyński

et al. 2020

Mycoses

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Summary Invasive pulmonary aspergillosis (IPA) optimal duration of antifungal treatment is not known. In a joint effort, four international scientific societies/groups performed a survey to capture current practices in European haematology centres regarding management of IPA. We conducted a cross‐sectional internet‐based questionnaire survey in 2017 to assess practices in sixteen European countries concerning IPA management in haematology patients including tools to evaluate treatment response, duration and discontinuation. The following four groups/societies were involved in the project: European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Fungal Infection Study Group (EFISG), Infectious Diseases Working Party‐European Society for Blood and Bone Marrow Transplantation (IDWP‐EBMT), European Organisation for Research and Treatment‐Infectious Disease group (EORTC‐IDG) and Sorveglianza Epidemiologica Infezioni nelle Emopatie (SEIFEM). A total of 112 physicians from 14/16 countries answered the survey. Galactomannan antigen was available in serum and bronchoalveolar lavage in most centres (106/112 [95%] and 97/112 [87%], respectively), quantitative Aspergillus PCR in 27/112 (24%) centres, β‐D‐glucan in 24/112 (21%) and positron emission tomography in 50/112 (45%). Treatment duration differed between haematological malignancies, with a median duration of 6 weeks [IQR 3‐12] for patients with AML, 11 [4‐12] for patients with allogenic stem cell transplantation and GvHD and 6 [3‐12] for patients with lymphoproliferative disease. Treatment duration significantly differed according to country. Essential IPA biomarkers are not available in all European countries, and treatment duration is highly variable according to country. It will be important to provide guidelines to help with IPA treatment cessation with algorithms according to biomarker availability.

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Section: Discussionmentioning

confidence: 93%

Invasive pulmonary aspergillosis treatment duration in haematology patients in Europe: An EFISG, IDWP‐EBMT, EORTC‐IDG and SEIFEM survey

Seidel

Pagano

Styczyński

et al. 2020

Mycoses

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“…Follow‐up chest CT in invasive pulmonary aspergillosis is advisable on day 7 post initiation of treatment (two points), day 14 (three points), and in case of clinical deterioration on day 21, but in case of clinical success on day 28 (two points) to document course of treatment . CT scans should be done at optimised, that is as low as reasonably achievable dose (Figure ) …”

Section: Resultsmentioning

confidence: 99%

“…The EQUAL Aspergillosis Score 2018 is a 16‐item scoring tool, derived from current guidelines and management path publications, to inform about quality of clinical invasive pulmonary aspergillosis care . From these documents we weighed the strongest recommendations on diagnosis, treatment, and follow‐up.…”

Section: Discussionmentioning

confidence: 99%

“…Follow‐up is important because it determines the duration of treatment of invasive pulmonary aspergillosis. Main uncertainties concern timing of follow‐up imaging and of treatment cessation . Both aspects are not specifically addressed in current guidelines, which reflects the lack of published literature .…”

Section: Discussionmentioning

confidence: 99%

“…First, we selected “AI” and “AII” recommendations. Then we added aspects that are part of a complete work‐up, but are either recommended with a lower grade of evidence or not specifically recommended in current guidelines . In a last step we allocated score points along the guideline levels of evidence and the clinical importance regarding complete work up (Figures and ).…”

Section: Methodsmentioning

confidence: 99%

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EQUAL Aspergillosis Score 2018: An ECMM score derived from current guidelines to measure QUALity of the clinical management of invasive pulmonary aspergillosis

Cornely

Köehler

Arenz

et al. 2018

Mycoses

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Invasive pulmonary aspergillosis is a serious threat to immunocompromised and critical care patients. Recent detailed guidelines and treatment algorithms lead microbiologists and clinicians in diagnosis and treatment of invasive aspergillosis. Currently, there is no tool available that allows to measure guideline adherence. To develop such a tool, we reviewed current guidelines provided by five scientific societies (European Society for Clinical Microbiology and Infectious Diseases, European Confederation of Medical Mycology, European Respiratory Society, Infectious Diseases Society of America (IDSA), and Infectious Diseases Working Party of the German Society for Hematology and Medical Oncology) and selected the strongest recommendations for management as key components for our scoring tool. We integrated diagnostic measures (chest computed tomography, bronchoalveolar lavage with galactomannan, fungal culture, fungal polymerase chain reaction analysis, species identification, susceptibility testing, histology with silver stain, Periodic acid-Schiff staining, and molecular diagnostics), treatment (antifungal choice and therapeutic drug monitoring), and follow-up computed tomography. The EQUAL Aspergillosis Score 2018 aggregates and weighs the components and provides a tool to support antifungal stewardship and to quantify guideline adherence.

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Therapie von Infektionen bei Tumorpatienten

Schmidt‐Hieber

Teschner

Desole

et al. 2022

Springer Reference Medizin

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Serial assessment of pulmonary lesion volume by computed tomography allows survival prediction in invasive pulmonary aspergillosis

Abstract: • CT evaluation offers good prediction of outcome for invasive pulmonary aspergillosis. • Predictive capability exceeds galactomannan, blood counts, and lesion count. • Any progression between day 7 and day 14 constitutes a high-risk scenario.

Cited by 34 publications

References 26 publications

Invasive pulmonary aspergillosis treatment duration in haematology patients in Europe: An EFISG, IDWP‐EBMT, EORTC‐IDG and SEIFEM survey

Invasive pulmonary aspergillosis treatment duration in haematology patients in Europe: An EFISG, IDWP‐EBMT, EORTC‐IDG and SEIFEM survey

EQUAL Aspergillosis Score 2018: An ECMM score derived from current guidelines to measure QUALity of the clinical management of invasive pulmonary aspergillosis

Therapie von Infektionen bei Tumorpatienten

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