Limited utility of serum galactomannan assay after auto-sct

Access through your institution Buy or subscribe Invasive _Aspergillosis_ (IA) is a dreaded infectious complication among immunocompromised patients, including those receiving treatment for

hematologic malignancies. Preemptive diagnosis of IA, using serum markers alone or in combination with computed tomography (CT), has received significant attention over the last decade but

remains controversial.1, 2, 3 In 2003, an ELISA to detect serum galactomannan (GM) was approved by the US Food and Drug Administration.4 In a meta-analysis of 27 studies using the GM assay

for surveillance, the sensitivity and specificity were 71 and 80%, respectively, for cases of definite IA. However, there was significant heterogeneity among studies. Also, most studies of

serum GM have included patients with acute leukemia or allogeneic hematopoietic SCT recipients. In these populations, the risk for IA varies between 5 and 15%.5, 6, 7, 8, 9 In contrast, IA

among autoSCT recipients is significantly less common, ranging between 0 and 8%.5, 7, 8, 9 This lower risk raises the question whether the GM assay has utility among auto-SCT recipients.

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calculated during checkout ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support REFERENCES * Maertens J, Theunissen K,

Verhoef G, Verschakelen J, Lagrou K, Verbeken E _et al_. Galactomannan and computed tomography-based preemptive antifungal therapy in neutropenic patients at high risk for invasive fungal

infection: a prospective feasibility study. _Clin Infect Dis_ 2005; 41: 1242–1250. Article  CAS  Google Scholar  * Marino IR, Panarello G, Singh N . Efficacy of Aspergillus

galactomannan-directed preemptive therapy for the prevention of invasive _aspergillosis_ in organ transplant recipients. _Transpl Infect Dis_ 2002; 4: 226–227; author reply. Article  CAS 

Google Scholar  * Maertens J, Deeren D, Dierickx D, Theunissen K . Preemptive antifungal therapy: still a way to go. _Curr Opin Infect Dis_ 2006; 19: 551–556. Article  Google Scholar  *

Rapid test for Aspergillus infection. _FDA Consum_ 2003; 37: 7. * Sinko J, Csomor J, Nikolova R, Lueff S, Krivan G, Remenyi P _et al_. Invasive fungal disease in allogeneic hematopoietic

stem cell transplant recipients: an autopsy-driven survey. _Transpl Infect Dis_ 2008; 10: 106–109. Article  CAS  Google Scholar  * Steinbach WJ, Addison RM, McLaughlin L, Gerrald Q, Martin

PL, Driscoll T _et al_. Prospective Aspergillus galactomannan antigen testing in pediatric hematopoietic stem cell transplant recipients. _Pediatr Infect Dis J_ 2007; 26: 558–564. Article 

Google Scholar  * Rooney S, Sekiguchi J, Zhu C, Cheng HL, Manis J, Whitlow S _et al_. Leaky Scid phenotype associated with defective V(D)J coding end processing in Artemis-deficient mice.

_Mol Cell_ 2002; 10: 1379–1390. Article  CAS  Google Scholar  * Pagano L, Caira M, Nosari A, Van Lint MT, Candoni A, Offidani M _et al_. Fungal infections in recipients of hematopoietic stem

cell transplants: results of the SEIFEM B-2004 study—Sorveglianza Epidemiologica Infezioni Fungine Nelle Emopatie Maligne. _Clin Infect Dis_ 2007; 45: 1161–1170. Article  CAS  Google

Scholar  * Post MJ, Lass-Floerl C, Gastl G, Nachbaur D . Invasive fungal infections in allogeneic and autologous stem cell transplant recipients: a single-center study of 166 transplanted

patients. _Transpl Infect Dis_ 2007; 9: 189–195. Article  CAS  Google Scholar  * Ascioglu S, Rex JH, de Pauw B, Bennett JE, Bille J, Crokaert F _et al_. Defining opportunistic invasive

fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: an international consensus. _Clin Infect Dis_ 2002; 34: 7–14. Article  CAS  Google

Scholar  Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Medicine, From the Infectious Disease Service, Memorial Sloan-Kettering Cancer Center, New York, NY,

USA A Jathavedam, D C Duré, Y Taur & D M Weinstock * Department of Medicine, Adult Allogeneic Bone Marrow Transplant Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA D

M Weinstock Authors * A Jathavedam View author publications You can also search for this author inPubMed Google Scholar * D C Duré View author publications You can also search for this

author inPubMed Google Scholar * Y Taur View author publications You can also search for this author inPubMed Google Scholar * D M Weinstock View author publications You can also search for

this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to D M Weinstock. ADDITIONAL INFORMATION CONFLICT OF INTEREST The authors do not have a commercial or other

association that might pose a conflict of interest (for example, pharmaceutical stock ownership, consultancy, advisory board membership, relevant patents or research funding). Financial

support was provided by the MSKCC Department of Medicine. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Jathavedam, A., Duré, D., Taur, Y. _et al._

Limited utility of serum galactomannan assay after auto-SCT. _Bone Marrow Transplant_ 44, 59–61 (2009). https://doi.org/10.1038/bmt.2008.425 Download citation * Published: 12 January 2009 *

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