Real life performance of serum GM for invasive aspergillosis in allogeneic HSCT recipients

Ref ID: 19416

Author:

M. Mikulska,1 E. Furfaro,2 V. Del Bono,2 A. M. Raiola3 and
A. Bacigalupo3

Author address:

1IRCCS – San Martino University Hospital-IST, Genova, Italy;
2Division of Infectious Diseases, IRCCS – San Martino University
Hospital-IST, Genova, Italy and 3Division of Hematology and
HSCT Unit, IRCCS-San Martino University Hospital-IST, Genova,

Full conference title:

6th Trends in Medical Mycology 2013

Date: 11 October 2014

Abstract:

Objectives Galactomannan (GM) is a well-established non-culture-
based assay for the diagnosis of invasive aspergillosis (IA) in high risk
patients. Among others, it’s performance is influenced by the type of
the underlying disease and the presence of neutropenia.
The aim of this study was to evaluate real life performance of
serum GM in allogeneic HSCT recipients in our center, 15 years after
its introduction into clinical practice.
Methods Allogeneic HSCT recipients are routinely screened for
serum GM: twice weekly during the first 100 days after transplant,
than once weekly or when clinically indicated.
The clinical records and GM results of all the patients who received
allogeneic HSCT between 01/01/2007 and 30/06/2012 were
reviewed. For patients with IA, only samples from the period of infec-
tion were considered.
Patients were classified as proven, probable, possible or no IA
according to 2008 EORTC/MSG criteria. Patients with proven or
probable IA were included as cases, those with no aspergillosis were
considered controls. Subjects diagnosed with IA but with radiological
findings that were not typical according to 2008 EORTC/MSG crite-
ria were excluded. Early IA was defined as occurring within 40 days
after HSCT.
Testing for GM was performed with Platelia Aspergillus assay and
samples with the optical density index (ODI) 0.5 were considered
positive.
Results During the observation period 501 allogeneic HSCT were
performed and over 19.000 serum samples were tested for GM.
Sixty six patients were diagnosed with proven/probable IA, in med-
ian 22 days after HSCT (range: -29, +495). Among them, 41 had
early IA. Fifteen 15 patients with IA and atypical radiological find-
ings were excluded, while the remaining 420 patients had no IA.
The results of the GM performance are shown in Table 1. False
negative results were diagnosed mainly with GM in BAL, and only in
one case with sputum culture.

Abstract Number: p178

Conference Year: 2013

Link to conference website: NULL

New link: NULL

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