Strong Correlation between Serum Aspergillus Galactomannan Index and Outcome of Aspergillosis in Patients with Hematological Cancer: Clinical and Research Implications

Background. Galactomannan is an Aspergillus-specific polysaccharide released during aspergillosis and is detected by the quantitative serum galactomannan index (GMI) test. Preclinical and preliminary clinical reports have suggested a good correlation between GMI and aspergillosis outcome. Methods. W...

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Bibliographic Details
Published in:Clinical infectious diseases 2008-05, Vol.46 (9), p.1412-1422
Main Authors: Miceli, Marisa H., Grazziutti, Monica L., Woods, Gail, Zhao, Weizhi, Kocoglu, Mehmet H., Barlogie, Bart, Anaissie, Elias
Format: Article
Language:English
Subjects:
Antifungals
Antigens
Articles and Commentaries
Aspergillosis
Aspergillosis - blood
Aspergillosis - complications
Aspergillosis - pathology
Aspergillus
Aspergillus - drug effects
Aspergillus - metabolism
Autopsies
Cancer
Clinical outcomes
Correlation analysis
Correlations
Health outcomes
Hematologic Neoplasms - complications
Hematology
Humans
Mannans - blood
Medical research
Meta-Analysis as Topic
Pediatrics
Prognosis
Prospective studies
Respiratory diseases
Survival Analysis
Treatment Outcome
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Summary:Background. Galactomannan is an Aspergillus-specific polysaccharide released during aspergillosis and is detected by the quantitative serum galactomannan index (GMI) test. Preclinical and preliminary clinical reports have suggested a good correlation between GMI and aspergillosis outcome. Methods. We reviewed the literature to assess the strength of correlation between GMI and aspergillosis outcome using the κ correlation coefficient. We included 27 studies that enrolled patients with hematological cancer and proven or probable aspergillosis and that used sequential GMI testing. We examined the 3 following outcomes: survival (survival vs. death), global outcome (survival vs. death [including autopsy findings]), and autopsy outcome (autopsy findings only). Results. Overall, 257 patients fulfilled criteria for proven or probable aspergillosis and were eligible for outcome evaluation. Correlation between GMI (within ≤1 week before outcome) and defined outcomes was excellent, with κ correlation coefficients of 0.8737 (95% confidence interval, 0.8140–0.9333; P
ISSN:1058-4838
1537-6591
DOI:10.1086/528714