False-positive Aspergillus galactomannan and its kinetics in allogeneic hematopoietic stem cell transplantation

Shun ichi Kimura, Yu Akahoshi, Hirofumi Nakano, Naonori Harada, Kazuaki Kameda, Tomotaka Ugai, Hidenori Wada, Ryoko Yamasaki, Yuko Ishihara, Koji Kawamura, Kana Sakamoto, Masahiro Ashizawa, Miki Sato, Kiriko Terasako-Saito, Hideki Nakasone, Misato Kikuchi, Rie Yamazaki, Junya Kanda, Shinichi Kako, Aki TaniharaJunji Nishida, Yoshinobu Kanda

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)520-540
Number of pages21
JournalJournal of Infection
Volume70
Issue number5
DOIs
Publication statusPublished - 2015 May 1
Externally publishedYes

Keywords

  • Allogeneic hematopoietic stem cell transplantation
  • Aspergillus galactomannan
  • False-positive
  • Kinetics of aspergillus galactomannan

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Fingerprint Dive into the research topics of 'False-positive Aspergillus galactomannan and its kinetics in allogeneic hematopoietic stem cell transplantation'. Together they form a unique fingerprint.

  • Cite this

    Kimura, S. I., Akahoshi, Y., Nakano, H., Harada, N., Kameda, K., Ugai, T., Wada, H., Yamasaki, R., Ishihara, Y., Kawamura, K., Sakamoto, K., Ashizawa, M., Sato, M., Terasako-Saito, K., Nakasone, H., Kikuchi, M., Yamazaki, R., Kanda, J., Kako, S., ... Kanda, Y. (2015). False-positive Aspergillus galactomannan and its kinetics in allogeneic hematopoietic stem cell transplantation. Journal of Infection, 70(5), 520-540. https://doi.org/10.1016/j.jinf.2015.02.012