Correlation Between Circulating Fungal Biomarkers and Clinical Outcome in Invasive Aspergillosis

Ref ID: 18668

Author:

D. Neofytos, MD – Assist. Prof.1, K. Mullane, DO – Investigator 2, D. Fredricks, MD – Assoc. Prof. 3, B. Granwehr, MD – Assist. Prof. 4, K. Marr, MD – Prof. 1, N. Almyroudis, MD – Assist. Prof. 5, D. Kontoyiannis, MD – Prof. 4, J. Maertens, MD – Prof

Author address:

1Johns Hopkins Univ., Baltimore, MD, 2Univ. of Chicago, Chicago, IL, 3Fred Hutchinson Ctr., Seattle, WA, 4Univ. of Texas, MD Anderson, Houston, TX, 5Roswell Park Cancer Inst., SUNY, Buffalo, NY, 6UZ Leuven, Gasthuisberg, Belgium, 7Merck, Whitehouse S

Full conference title:

52nd Annual ICAAC

Date: 9 September 2014

Abstract:

Background: Biomarkers could enable earlier, quantifiable evaluation of treatment efficacy for invasive aspergillosis (IA). Methods: Patients with possible, probable, or proven IA were enrolled within 72 hours prior to, or 24 hours following initiation of antifungal therapy at 18 sites. A probable/proven diagnosis was established within 2 weeks (w) to be evaluable. Serum galactomannan (SGM) and β -D-glucan (β DG) concentrations were measured at baseline, twice/w for the first 6w, then weekly through 12w. Global response (GR; success-S vs. failure-F) according to a composite score (clinical, radiographic, microbiological) and survival (alive-A vs. dead-D) were assessed at 6 and 12w. Results: Of 116 enrolled patients, 51 had proven (8; 15.7%) or probable (43; 84.3%) IA; 50 patients were evaluable. SGM (Platelia Aspergillus EIA, BioRad, ng/mL) remained undetectable for 30 patients. The mean difference of the composite of the z-scores of the time-weighted averages of SGM and β DG: (a) during the first 2w for (i) S and F at 6w was 0.28 (p=0.17; all patients) and 0.38 (p=0.24; excluding patients with negative baseline SGM-negSGM (post-hoc analysis)), (ii) A and D patients at 12w was 0.74 (p=0.02; all patients) and 0.61 (p=0.13; excluding patients with negSGM), (b) during the first 6w for (i) S and F at 12w was 0.65 (p=0.03; all patients) and 0.86 (p=0.07; excluding patients with negSGM), (ii) A and D patients at 12w was 0.97 (p=0.004; all patients) and 0.92 (p=0.05; excluding patients with negSGM). Conclusions: Quantitative SGM and β DG within the first 2w of treatment do not predict 6w-GR, but may predict 12w survival. Quantitative values measured within the first 6w are relatively more predictive of 12w survival and GR.

Abstract Number: M-1676

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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