Koo et al used the trend in galactomannan antigenemia to evaluate patients with galactomannan-positive invasive Aspergillosis. The change over has prognostic signficance for these patients. The authors are from Brigham & Women’s Hospital, Dana Farber Cancer Institute and Harvard University in Boston.
Patient selection: invasive Aapergillosis with galactomannan antigenemia (serum galactomannan >= 0.5 units on Platelia enzyme immunoassay, Bio-Rad Laboratories)
Parameters:
(1) baseline serum galactomannan (GM)
(2) serum galactomannan (GM) after 1 week of therapy
galactomman decay after 1 week =
= ((baseline GM) – (GM at 1 week)) / (1 week)
galactomannan decay after n weeks in unit decline per week =
= ((baseline GM) – (GM after n weeks)) / (n weeks)
Factors affecting all-cause mortality at 6 weeks:
(1) initial serum level of GM (HR 1.25 per EIA unit increase)
(2) decay of GM level over time (HR 0.78 per EIA unit per week decline; HR 1.28 per EIA unit per week increase)
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