DIAGNOSTIC VALUE OF SERUM GALACTOMANNAN AND CHEST COMPUTED TOMOGRAPHY FOR INVASIVE ASPERGILLOSIS IN PATIENTS WITH ACUTE LEUKEMIA
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Abstract
Objective: To assess the diagnostic value of serum galactomannan (GM) and chest computed tomography (CT) through their result distribution, GM–CT relationship, and EORTC/MSG 2008 classification in patients with acute leukemia.
Methods: This retrospective analytical cross-sectional study included 481 patients aged ≥15 years with acute leukemia evaluated for invasive aspergillosis (IA) at the National Institute of Hematology and Blood Transfusion from January 2022 to October 2024. Each patient contributed one evaluation episode; serum GM and chest CT were performed within 7 days. GM was measured using the Platelia™ Aspergillus Ag ELISA; ODI ≥0.5 was used for analysis. IA was classified according to EORTC/MSG 2008.
Results: Mean age was 53 ± 17 years and 53.4% were male. Probable IA, possible IA, and cases not meeting IA criteria accounted for 6.2%, 27.4%, and 66.4%, respectively. GM ≥0.5 was found in 101/481 (21.0%), and 162/481 (33.7%) had CT lesions suspicious for IA. Thirty patients (6.2%) had both GM ≥0.5 and CT abnormalities; pulmonary nodules were present in 86.7%, halo sign in 66.7%, consolidation in 43.3%, cavitation in 10.0%, and air-crescent sign in 6.7%. GM–CT results were discordant in 203/481 (42.2%). Dichotomized GM was not associated with CT status (Pearson χ²=0.905; p=0.341; OR=0.79; 95% CI: 0.49–1.28). GM was performed on average 0.4 days earlier than CT (p=0.012).
Conclusion: Serum GM and chest CT provide complementary rather than interchangeable information in the evaluation of IA. Because GM and imaging criteria are incorporated into the EORTC/MSG 2008 framework, that classification should not be used as an independent reference standard to claim the diagnostic performance of GM or CT.
Keywords
Invasive aspergillosis, galactomannan, acute leukemia, chest CT, EORTC/MSG
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References
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