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Open AccessArticle

A Mortality Prediction Rule for Hematology Patients with Invasive Aspergillosis Based on Serum Galactomannan Kinetics

1
KU Leuven, Department of Microbiology, Immunology and Transplantation, 3000 Leuven, Belgium
2
Department of Hematology, University Hospitals Leuven, 3000 Leuven, Belgium
3
Division of Infectious Diseases, University Medicine Cluster, National University Health System, Singapore and Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119074, Singapore
4
Department of Laboratory Medicine and National Reference Center for Mycosis, University Hospitals Leuven, 3000 Leuven, Belgium
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(2), 610; https://doi.org/10.3390/jcm9020610
Received: 22 January 2020 / Revised: 11 February 2020 / Accepted: 19 February 2020 / Published: 24 February 2020
(This article belongs to the Special Issue Advances in Acute Myeloid Leukemia)
In invasive aspergillosis (IA), an early and adequate assessment of the response to the initial antifungal therapy remains problematic. We retrospectively analyzed 206 hematology patients with proven or probable IA, and collected serial serum galactomannan (sGM) values and survival status through week 6 and week 12. We created a model for survival at week 6 based on the sGM taken at baseline and on early sGM kinetics. This resulted in a rule predicting that patients with a baseline sGM index >1.4, who failed to lower that index to <0.5 after one week, had a mortality rate of 48.1% at week 6. Conversely, patients presenting with a baseline sGM index ≤1.4 that obtained a negative sGM (<0.5) after one week, had a mortality that was almost five times lower at only 10.1% by week 6. These findings were confirmed in an external cohort from an independent prospective study. In conclusion, sGM kinetics correlate well with treatment outcomes in hematology patients with IA. We present a rule which is easy to use at the bedside and has good accuracy in predicting week 6 survival. View Full-Text
Keywords: invasive aspergillosis; galactomannan; kinetics; prognosis; outcome; mortality invasive aspergillosis; galactomannan; kinetics; prognosis; outcome; mortality
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MDPI and ACS Style

Mercier, T.; Wera, J.; Chai, L.Y.A.; Lagrou, K.; Maertens, J. A Mortality Prediction Rule for Hematology Patients with Invasive Aspergillosis Based on Serum Galactomannan Kinetics. J. Clin. Med. 2020, 9, 610.

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