TY - JOUR
T1 - False-positive Aspergillus galactomannan and its kinetics in allogeneic hematopoietic stem cell transplantation
AU - Kimura, Shun ichi
AU - Akahoshi, Yu
AU - Nakano, Hirofumi
AU - Harada, Naonori
AU - Kameda, Kazuaki
AU - Ugai, Tomotaka
AU - Wada, Hidenori
AU - Yamasaki, Ryoko
AU - Ishihara, Yuko
AU - Kawamura, Koji
AU - Sakamoto, Kana
AU - Ashizawa, Masahiro
AU - Sato, Miki
AU - Terasako-Saito, Kiriko
AU - Nakasone, Hideki
AU - Kikuchi, Misato
AU - Yamazaki, Rie
AU - Kanda, Junya
AU - Kako, Shinichi
AU - Tanihara, Aki
AU - Nishida, Junji
AU - Kanda, Yoshinobu
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Objectives: We evaluated the incidence of and risk factors for false-positive Aspergillus galactomannan (GM) antigenemia in allogeneic hematopoietic stem cell transplantation (HSCT). We also focused on the GM index value and its kinetics. Methods: Patients who underwent their first allogeneic HSCT at our center between June 2007 and December 2012 were included (n=172). Episodes of positive GM tests were classified as either "true-positive", which fulfilled the EORTC criteria for proven or probable invasive aspergillosis (IA), or "false-positive", which was not accompanied by clinical findings. The remaining cases were regarded as "inconclusive". Results: The one-year cumulative incidences of IA and positive GM tests were 10.1% and 48.1%, respectively. Among 148 episodes of positive GM tests, 97(65.5%), 23(15.5%), and 28(19.0%) were classified as false-positive, true-positive and inconclusive, respectively. In the first episodes of positive GM tests in each patient (false-positive=67, others=30), an increase in the GM value in the first two measurements, neutropenia, and use of anti-mold agents at positive GM episode were associated with a significantly lower possibility of false-positive results according to a multivariate analysis. Conclusions: A false-positive GM test was frequently seen after allogeneic HSCT. An increase in the GM value may increase its positive predictive value.
AB - Objectives: We evaluated the incidence of and risk factors for false-positive Aspergillus galactomannan (GM) antigenemia in allogeneic hematopoietic stem cell transplantation (HSCT). We also focused on the GM index value and its kinetics. Methods: Patients who underwent their first allogeneic HSCT at our center between June 2007 and December 2012 were included (n=172). Episodes of positive GM tests were classified as either "true-positive", which fulfilled the EORTC criteria for proven or probable invasive aspergillosis (IA), or "false-positive", which was not accompanied by clinical findings. The remaining cases were regarded as "inconclusive". Results: The one-year cumulative incidences of IA and positive GM tests were 10.1% and 48.1%, respectively. Among 148 episodes of positive GM tests, 97(65.5%), 23(15.5%), and 28(19.0%) were classified as false-positive, true-positive and inconclusive, respectively. In the first episodes of positive GM tests in each patient (false-positive=67, others=30), an increase in the GM value in the first two measurements, neutropenia, and use of anti-mold agents at positive GM episode were associated with a significantly lower possibility of false-positive results according to a multivariate analysis. Conclusions: A false-positive GM test was frequently seen after allogeneic HSCT. An increase in the GM value may increase its positive predictive value.
KW - Allogeneic hematopoietic stem cell transplantation
KW - Aspergillus galactomannan
KW - False-positive
KW - Kinetics of aspergillus galactomannan
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U2 - 10.1016/j.jinf.2015.02.012
DO - 10.1016/j.jinf.2015.02.012
M3 - Article
C2 - 25743584
AN - SCOPUS:84926999717
VL - 70
SP - 520
EP - 540
JO - Journal of Infection
JF - Journal of Infection
SN - 0163-4453
IS - 5
ER -
