Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

21 May 2009

Diagnostic and treatment strategy of invasive aspergillosis based on galactomannan screenning – prospective analysis of 268 patients after hematopoietic stem cell transplantation

L Gil, M Kozlowska-Skrzypczak, A Czyz, A Lojko-Dankowska, A Nowicki, M Komarnicki

Ann Transplant 2009; 14(1): 21-22 :: ID: 880276

Abstract

Background: The outcome of invasive aspergillosis (IA) after hematopoietic
stem cell transplantation (HSCT) depends on early diagnosis and treatment initiation. The aim of the study was to assess the efficacy of Aspergillus' antigen galactomannan-based diagnostic and treatment strategy in HSCT recipients.
Material/Methods: A total of 268 patients (median age 42; range 18-68) undergoing autologous (181) or allogeneic (87) HSCT were prospectively analyzed. All patients were monitored with twice-weekly serum galactomannan (GM) test. High resolution thoracic tomography (HRCT) and bronchoscopy with lavage were performed in case of positive GM test, persistent fever or pulmonary infiltrates. The diagnosis of IA was made according to EORTC/MSG criteria.
Results: Among patients after allogeneic HSCT documented IA was diagnosed in 17 (19.5%) patients (4 proven, 13 probable) and possible in 13 (15%). Median time to diagnosis of documented IA was 69 (range; 10-515) days. After autologous HSCT documented IA was established in 12 (6.5%) patients (5 proven, 7 probable) and possible in 48 (25.5%). Median time to diagnosis of documented IA in this group was 15 (range; 8-38) days. All patients with documented IA were treated with voriconazole. In 12 weeks follow up 11 (38%) patients died because of IA. In case of possible IA, amphotericin B or caspofungin were used. In this group 4 patients died due to confirmed bacterial infection. In summary: IA represents serious infectious complication both after allogeneic and autologous HSCT. Strategy based on GM screening, HRCT and bronchoscopy allows early diagnosis of IA and early pre-emptive or targeted therapy.

Keywords: fungal infections, Stem Cell Transplantation

Comments

In Press

06 May 2022 : Original article  

Phosphatidylethanol (PEth) for Monitoring Sobriety in Liver Transplant Candidates: Preliminary Results of D...

Ann Transplant In Press; DOI: 10.12659/AOT.936293  

27 Apr 2022 : Review article  

A Systematic Review of the Literature on Chronic Kidney Disease Following Liver Transplantation

Ann Transplant In Press; DOI: 10.12659/AOT.935170  

Most Viewed Current Articles

31 Dec 1969 : Original article  

Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...

DOI :10.12659/AOT.933588

Ann Transplant 2021; 26:e933588

31 Dec 1969 : Review article  

Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models

DOI :10.12659/AOT.934924

Ann Transplant 2022; 27:e934924

31 Dec 1969 : Review article  

Kidney Transplantation in the Times of COVID-19 – A Literature Review

DOI :10.12659/AOT.925755

Ann Transplant 2020; 25:e925755

31 Dec 1969 : Case report  

Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...

DOI :10.12659/AOT.935860

Ann Transplant 2022; 27:e935860

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358