title: Serum Aspergillus galactomannan antigen values strongly correlate with outcome of invasive aspergillosis: a study of 56 patients with hematologic cancer.
abstract: BACKGROUND
  Determining the outcome of patients with aspergillosis can be particularly difficult because patients with aspergillosis are at risk for other conditions that mimic this infection. Galactomannan is an Aspergillus-specific antigen released during invasive aspergillosis and is detected by the quantitative serum galactomannan index (GMI) test.
  
  
  METHODS
  Using a kappa correlation coefficient test (KCC), the strength of correlation was determined between GMI and survival outcome of aspergillosis among 56 adults with hematologic cancer (90% had myeloma) who underwent serial GMI monitoring until hospital discharge or death.
  
  
  RESULTS
  All 56 patients received antineoplastic therapy (myeloablative followed by stem cell transplantation [autologous in 21 patients and allogeneic in 3 patients] or nonmyeloablative therapy [32 patients]). The overall correlation between survival outcome and GMI was excellent (KCC = 0.8609; 95% confidence interval [95% CI], 0.7093-1.000 [P < .0001]) and was comparable among neutropenic and nonneutropenic patients (KCC = 0.8271; 95% CI, 0.6407-1.000 [P < .0001] and KCC = 1.0; 95% CI, 1-1 [P = .0083], respectively).
  
  
  CONCLUSIONS
  The survival outcome of patients with aspergillosis strongly correlated with serum GMI. These findings have important implications for patient care and clinical trials of mold-active antifungal agents.
authors.affiliation: Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
authors.forename: Gail
authors.initials: G
authors.lastname: Woods
authors.forename: Marisa H
authors.initials: MH
authors.lastname: Miceli
authors.forename: Monica L
authors.initials: ML
authors.lastname: Grazziutti
authors.forename: Weizhi
authors.initials: W
authors.lastname: Zhao
authors.forename: Bart
authors.initials: B
authors.lastname: Barlogie
authors.forename: Elias
authors.initials: E
authors.lastname: Anaissie
mesh_terms: D000328:Adult; D000368:Aged; D000946:Antigens, Fungal / Q000097:blood*; D001228:Aspergillosis / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D001230:Aspergillus / Q000254:growth & development / Q000276:immunology*; D003131:Combined Modality Therapy; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005690:Galactose / Q000031:analogs & derivatives; D005938:Glucocorticoids / Q000627:therapeutic use; D019337:Hematologic Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D008297:Male; D008351:Mannans / Q000097:blood*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D011237:Predictive Value of Tests; D011379:Prognosis; D033581:Stem Cell Transplantation; D016019:Survival Analysis
chemical_list: D000946:Antigens, Fungal; D005938:Glucocorticoids; D008351:Mannans; C012990:galactomannan; D003907:Dexamethasone; D005690:Galactose