Utility of serum galactomannan antigen for diagnosis and follow-up of invasive aspergillosis in hematological patients
XU Ming-zhu, SUN Ai-ning, WU De-pei, QIU Hui-ying, TANG Xiao-wen, FU Zheng-zheng, JING Zheng-ming, MIAO Miao, HAN Yue. (First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis, Ministry of Health, Suzhou 215006, China)
Objective To assess the value of serial measurements of serum galactomannan (GM) antigen for early diagnosis and follow-up of invasive aspergillosis (IA). Methods Serum GM level of 613 samples from 172 hematological patients was determined by Platelia Aspergillus double-sandwich enzyme linked immunosorbent assay. Positive GM result was defined as A index 0.5 in two consecutive measurements or 0.7 in one measurement. The patients were managed with proactive antifungal therapy if GM test was positive.Results The sensitivity and specificity of the assay were 81.1% and 88.2%, respectively. The result was positive in 55 patients, and negative in 117 patients. The number of probable IA cases increased from 37 to 52 according to GM criteria. Of the 55 GM-positive patients, 38 were managed by proactive therapy against Aspergillus. Good response was achieved in 26 patients. And 12 (31.6%) died due to treatment failure. GM concentration was decreasing in patients who responded to antifungal therapy, but increasing in the patients with fatal outcomes. Conclusions Serum GM antigen is a reliable method for early diagnosis and treatment of IA. The dynamic change of GM level may be useful for assessing treatment response.