ECIL recommendations for the use of biological markers for the diagnosis of invasive fungal diseases in leukemic patients and hematopoietic SCT recipients

Malcolm Richardson, O. Marchetti, F. Lamoth, M. Mikulska, C. Viscoli, P. Verweij, S. Bretagne

    Research output: Contribution to journalArticlepeer-review

    Abstract

    As culture-based methods for the diagnosis of invasive fungal diseases (IFD) in leukemia and hematopoietic SCT patients have limited performance, non-culture methods are increasingly being used. The third European Conference on Infections in Leukemia (ECIL-3) meeting aimed at establishing evidence-based recommendations for the use of biological tests in adult patients, based on the grading system of the Infectious Diseases Society of America. The following biomarkers were investigated as screening tests: galactomannan (GM) for invasive aspergillosis (IA); β-glucan (BG) for invasive candidiasis (IC) and IA; Cryptococcus Ag for cryptococcosis; mannan (Mn) Ag/anti-mannan (A-Mn) Ab for IC, and PCR for IA. Testing for GM, Cryptococcus Ag and BG are included in the revised EORTC/MSG (European Organization for Research and Treatment of Cancer/Mycoses Study Group) consensus definitions for IFD. Strong evidence supports the use of GM in serum (A II), and Cryptococcus Ag in serum and cerebrospinal fluid (CSF) (A II). Evidence is moderate for BG detection in serum (B II), and the combined Mn/A-Mn testing in serum for hepatosplenic candidiasis (B III) and candidemia (C II). No recommendations were formulated for the use of PCR owing to a lack of standardization and clinical validation. Clinical utility of these markers for the early management of IFD should be further assessed in prospective randomized interventional studies. © 2012 Macmillan Publishers Limited All rights reserved.
    Original languageEnglish
    Pages (from-to)846-854
    Number of pages8
    JournalBone Marrow Transplantation
    Volume47
    Issue number6
    DOIs
    Publication statusPublished - Jun 2012

    Keywords

    • anti-mannan
    • Aspergillus PCR
    • b-glucan
    • Cryptococcus Ag
    • galactomannan
    • invasive fungal diseases
    • mannan

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