Galactomannan as a prognostic marker for poor outcome of invasive pulmonary mould infection in patients with haematological malignancies
Abstract number: P906
Weisser M., Blättler L., Elzi L., Steffen I., Gambazzi F., Orasch C., Stern M., Arber C., Heim D., Khanlari B., Conen A., Gratwohl A., Flückiger U.
Objectives: Little is known on prognostic factors for outcome of invasive mould infections in patients with haematological malignancies. Besides new prophylactic regimes, knowledge of predictors for therapy failure might improve outcome.
Methods: We analyzed cases of proven and probable invasive pulmonary mould infection in patients with haematological malignancies treated in a tertiary-care hospital from 20022008 with the aim to investigate risk factors for poor outcome.
Results: In 34 patients with probable (n = 18) and proven (n = 16) invasive pulmonary mould infection a galactomannan value of 0.5 ng/mL at the time of diagnosis was an independent risk factor of poor outcome at 6 months after diagnosis (HR 1.24, 95% CI 1.091.52, p 0.023). Age, gender, underlying disease, transplantation, use of steroids, duration of neutropenia, CT findings, surgery and antifungal treatment had no significant influence on the outcome. Under an antimould treatment (and thoracic surgery in 16 patients) a radiological resolution was seen in 20 patients (59%) after a median of 80 days. Cure at 6 months was reached in 24 patients (70.6%). Overall 23 patients (67.6%) died during the follow up. Three patients died of a mould infection corresponding to an attributable mortality of 8.8%.
Conclusion: The level of galactomannan at diagnosis of the fungal infection is predictive for poor outcome.
Figure 1. Kaplan-Meier curve of treatment failure within 6 months after diagnosis of invasive mould infection according to the initial galactomannan (GM) value.
|Session name:||19th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Helsinki, Finland, 16 - 19 May 2009|
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