Clinical utility and prognostic value of bronchoalveolar lavage galactomannan in patients with hematologic malignancies |
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| Authors: | Me-Linh Luong,Charles Filion,Annie-Claude Labbé ,Jean Roy,Jacques Pé pin,Julia Cadrin-Tourigny,Sté phane Carignan,Donald C. Sheppard,Michel Laverdiè re |
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| Affiliation: | 1. Department of Microbiology, McGill University Health Center, Montreal, Quebec H3A 2B4, Canada;2. Department of Microbiology, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Quebec H1T 2M4, Canada;3. Division of Hemato-Oncology, Department of Medicine, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Quebec H1T 2M4, Canada;4. Department of Microbiology and Infectious Diseases, Université de Sherbrooke, Sherbrooke, Quebec J1H 5N4, Canada;5. Department of Radiology, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Quebec H1T 2M4, Canada |
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| Abstract: | We conducted a single-center retrospective cohort study to determine the performance characteristics of the galactomannan (GM) assay in bronchoalveolar lavage (BAL) in patients with hematologic malignancies. Patients were classified as proven, probable, possible, or no invasive pulmonary aspergillosis (IPA), according to international guidelines. A total of 173 BAL samples from 145 patients were included. There were 5 proven, 7 probable, and 35 possible cases of IPA. Using a GM index cutoff of ≥0.5, the sensitivity, specificity, and positive and negative predictive values (PPV and NPV, respectively) of the BAL GM assay were 100%, 78%, 26%, and 100%, respectively. Using a GM index cutoff of ≥2.0, the sensitivity and NPV remained 100%, but specificity and PPV increased to 93% and 50%, respectively. The BAL GM assay is a highly sensitive screening test for IPA in patients with hematologic malignancies. Increasing the cutoff value to 2.0 would improve the performance of this assay. |
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| Keywords: | Aspergillosis Galactomannan Bronchoalveolar lavage Hematologic malignancies |
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