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Breakthrough invasive aspergillosis and diagnostic accuracy of serum galactomannan enzyme immune assay during acute myeloid leukemia induction chemotherapy with posaconazole prophylaxis

dc.rights.licenseopenen_US
dc.contributor.authorCALMETTES, C.
dc.contributor.authorGABRIEL, F.
dc.contributor.authorBLANCHARD, E.
dc.contributor.authorSERVANT, V.
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorBOUCHET, Stephane
dc.contributor.authorKABORE, N.
dc.contributor.authorFORCADE, E.
dc.contributor.authorLEROYER, C.
dc.contributor.authorBIDET, A.
dc.contributor.authorLATRABE, V.
dc.contributor.authorLEGUAY, T.
dc.contributor.authorVIGOUROUX, S.
dc.contributor.authorTABRIZI, R.
dc.contributor.authorBREILH, D.
dc.contributor.authorACCOCEBERRY, I.
dc.contributor.authorDE LARA, M. T.
dc.contributor.authorPIGNEUX, A.
dc.contributor.authorMILPIED, N.
hal.structure.identifierBiothérapies des maladies génétiques et cancers
dc.contributor.authorDUMAS, Pierre-Yves
dc.date.accessioned2020-10-27T11:16:26Z
dc.date.available2020-10-27T11:16:26Z
dc.date.issued2018-06-01
dc.identifier.issn1949-2553en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/11492
dc.description.abstractEnPosaconazole prophylaxis has demonstrated efficacy in the prevention of invasive aspergillosis during prolonged neutropenia following acute myeloid leukemia induction chemotherapy. Antifungal treatment decreases serum galactomannan enzyme immunoassay diagnostic accuracy that could delay the diagnosis and treatment. We retrospectively studied patients with acute myeloid leukemia who underwent intensive chemotherapy and antifungal prophylaxis by posaconazole oral suspension. Clinical, radiological, microbiological features and treatment response of patients with invasive aspergillosis that occurred despite posaconazole prophylaxis were analyzed. Diagnostic accuracy of serum galactomannan assay according to posaconazole plasma concentrations has been performed. A total of 288 patients with acute myeloid leukemia, treated by induction chemotherapy, who received posaconazole prophylaxis for more than five days were included in the present study. The incidence of invasive aspergillosis was 8% with 12 (4.2%), 8 (2.8%) and 3 (1%), possible, probable and proven invasive aspergillosis, respectively. Posaconazole plasma concentration was available for 258 patients. Median duration of posaconazole treatment was 17 days, and median posaconazole plasma concentration was 0.5 mg/L. None of patients with invasive aspergillosis and posaconazole concentration >/= 0.5 mg/L had a serum galactomannan positive test. Sensitivity of serum galactomannan assay to detect probable and proven invasive aspergillosis was 81.8%. Decreasing the cut-off value for serum galactomannan optical density index from 0.5 to 0.3 increased sensitivity to 90.9%. In a homogenous cohort of acute myeloid leukemia patients during induction chemotherapy, increasing the posaconazole concentration decreases the sensitivity of serum galactomannan assay.
dc.language.isoENen_US
dc.rightsAttribution 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/us/*
dc.title.enBreakthrough invasive aspergillosis and diagnostic accuracy of serum galactomannan enzyme immune assay during acute myeloid leukemia induction chemotherapy with posaconazole prophylaxis
dc.title.alternativeOncotargeten_US
dc.typeArticle de revueen_US
dc.identifier.doi10.18632/oncotarget.25477en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
bordeaux.journalOncotargeten_US
bordeaux.page26724-26736en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.issue9en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-02979835
hal.version1
hal.date.transferred2020-10-27T11:16:33Z
hal.exporttrue
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