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- Title
Role of pre‐transplant chest high‐resolution computed tomography and serum galactomannan index in predicting post‐transplant invasive pulmonary aspergillosis in allogeneic hematopoietic cell transplant recipients.
- Authors
Sharma, Rintu; Singh, Charanpreet; Khadwal, Alka; Prakash, Gaurav; Malhotra, Pankaj; Jain, Arihant; Jandial, Aditya; Suri, Vikas; Muthu, Valliappan; Prabhakar, Nidhi; Gorsi, Ujjwal; Chakrabarti, Arunaloke; Varma, Subhash; Lad, Deepesh P.
- Abstract
Introduction: The role of pre‐HCT chest high‐resolution computed tomography (HRCT) and serum galactomannan index (GMI) in predicting the post‐allogeneic hematopoietic cell transplant (HCT) invasive pulmonary aspergillosis (IPA) is debatable. Methods: This was a single‐center, prospective study from 2014 to 2019. The primary objective was to study if pre‐HCT chest HRCT and serum GMI predicted IPA post‐HCT. The secondary objective was day +100 mortality. All consecutive, consenting patients of ≥12 years of age undergoing allo‐HCT were included and had pre‐HCT chest HRCT and serum GMI. All patients received mold active antifungal prophylaxis. The EORTC/MSG criteria were used for the diagnosis of IPA. Results: A total of 82 patients with median age 27 years (12‐59 years) were included. The underlying diagnoses included hematological malignancies (79%) and aplastic anemia (21%). Fifteen percent of patients was treated for prior history of probable IPA (>6 weeks before HCT). Pre‐HCT chest HRCT satisfied EORTC clinical criteria in 24% patients. Serum GMI ≥0.5 was seen in 27% of patients. Post‐HCT probable IPA was seen in 24% of patients. There were more patients with pre‐HCT chest HRCT findings satisfying EORTC clinical criteria (45% vs. 18%, P =.014) and GMI ≥0.5 (45% vs. 21%, P =.03) in the group with post‐HCT IPA compared to those without IPA. There was higher day+100 mortality in patients with post‐HCT IPA (55% vs. 18%, P =.001). Conclusions: The presence of EORTC clinical criteria on pre‐HCT chest HRCT, serum GMI ≥0.5, and prior history of IPA predicted post‐HCT IPA.
- Subjects
PULMONARY aspergillosis; GALACTOMANNANS; APLASTIC anemia; HEMATOLOGIC malignancies; TRANSPLANTATION of organs, tissues, etc.
- Publication
Transplant Infectious Disease, 2021, Vol 23, Issue 4, p1
- ISSN
1398-2273
- Publication type
Article
- DOI
10.1111/tid.13632