Title: Galactomannan serves as a surrogate endpoint for outcome of pulmonary invasive aspergillosis in neutropenic hematology patients
Authors: Maertens, Johan ×
Buvé, Kristel
Theunissen, Koen
Meersseman, Wouter
Verbeken, Eric
Verhoef, Gregor
Van Eldere, Johan
Lagrou, Katrien #
Issue Date: Jan-2009
Publisher: John Wiley & Sons
Series Title: Cancer vol:115 issue:2 pages:355-362
Abstract: BACKGROUND: A noninvasive, objective, reproducible, and quantitative Aspergillus-specific surrogate marker is needed for a more accurate assessment of the outcome of invasive aspergillosis (IA) in patients with a hematologic disorder. The quantitative serum galactomannan index (GMI) assay seems to fulfill the requirements of surrogacy for outcome evaluation. METHODS: Kappa statistics were used to determine the strength of correlation between GMI outcome and clinical outcome (survival or death), autopsy data, and response outcome of IA in 70 adults with prolonged neutropenia. All patients underwent serial GMI monitoring until discharge or death. RESULTS: The overall correlation between GMI and clinical outcome was good at 6 weeks (kappa=0.5882; 95% confidence interval [95% CI], 0.4023-0.7741) and was excellent at 12 weeks (kappa=0.8857; 95% CI, 0.7766-0.9948). Concordance with autopsy findings was perfect (kappa=1). At 6 weeks, the correlation between GMI and response outcome (favorable or unfavorable) was excellent (kappa=0.7523; 95% CI, 0.5803-0.9243). Survival was significantly better in patients who became GMI-negative (P<.0001). CONCLUSIONS: In neutropenic patients with seropositive IA, serum galactomannan index outcome strongly correlates with survival, autopsy findings, and response outcome. This finding may have implications for patient management and for clinical trial design.
ISSN: 0008-543X
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Hematology Section (-)
Translational Cell & Tissue Research
Laboratory for Clinical Infectious and Inflammatory Disorders
Laboratory of Clinical Bacteriology and Mycology
Laboratory for Experimental and Clinical Microbiology (-)
× corresponding author
# (joint) last author

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