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Role of Nasal Lavage Fluid Galactomannan Levels for Diagnosis of Invasive Aspergillosis in Patients With Leukemia Publisher



Salehi M1 ; Hashemi SJ2 ; Khodavaisy S2 ; Emami AH3 ; Safaeenodehi SR3 ; Rasolinezhad M1 ; Ahmadikia K2 ; Dehghanmanshadi SA1 ; Abdollahi A4 ; Amali A5 ; Mokhtarian M1
Authors
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Authors Affiliations
  1. 1. Department of Infectious Diseases and Tropical Medicines, School of Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Adult Hematology and Oncology Ward, Cancer Institute, Imam Khomeini Hospital Complex, Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Pathology, School of Medicine, Thrombosis and Hemostasis Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Otorhinolaryngology, School of Medicine, Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran

Source: International Journal of Cancer Management Published:2021


Abstract

Background: Invasive aspergillosis (IA) is the most prevalent invasive infection with high mortality among patients with leukemia. Early diagnosis of IA has been a challenging topic in this group of patients. Objectives: In this study, we evaluated the galactomannan levels of nasal lavage fluid (NALF) as a possible auxiliary method for IA diagnosis in patients with leukemia. Methods: In a prospective study, 32 adult patients with leukemia who were taking induction and/or consolidation chemotherapy with fever and neutropenia were included. In all patients, galactomannan (GM) levels of serum and NALF, and mycological examinations were evaluated before the first dose of antifungal therapy. Results: Fourteen (43.7%) patients had NALF GM ≥ 0.5; however, in 16 (50%) patients the level of serum GM was ≥ 0.5. The elevated level of NALF GM had a significant association with the proven IA cases (P = 0.048). The GM level of NALF with a cut-off value of 0.45 (by receiver operating characteristic curve analysis) had 78% sensitivity and 64% specificity for the diagnosis of invasive aspergillosis (P = 0.033). Conclusions: Due to its non-invasive nature, GM level of NALF may be contributory to be used as part of the diagnostic work-up of IA particularly in leukemic patients with thrombocytopenia which prohibits acquiring bronchoalveolar lavage. © 2021, Author(s).