Galactomannan, β-D-Glucan, and Polymerase Chain Reaction-Based Assays for the Diagnosis of Invasive Fungal Disease in Pediatric Cancer and Hematopoietic Stem Cell Transplantation: A Systematic Review and Meta-Analysis

Thomas Lehrnbecher, Paula D. Robinson, Brian T. Fisher, Elio Castagnola, Andreas H. Groll, William J. Steinbach, Theoklis E. Zaoutis, Zelalem F. Negeri, Joseph Beyene, Bob Phillips, Lillian Sung

Research output: Contribution to journalReview article

Abstract

We systematically reviewed and analyzed the available data for galactomannan (GM), β-D-glucan (BG), and polymerase chain reaction (PCR)-based assays to detect invasive fungal disease (IFD) in patients with pediatric cancer or undergoing hematopoietic stem cell transplantation when used as screening tools during immunosuppression or as diagnostic tests in patients presenting with symptoms such as fever during neutropenia (FN). Of 1532 studies screened, 25 studies reported on GM (n = 19), BG (n = 3), and PCR (n = 11). All fungal biomarkers demonstrated highly variable sensitivity, specificity, and positive predictive values, and these were generally poor in both clinical settings. GM negative predictive values were high, ranging from 85% to 100% for screening and 70% to 100% in the diagnostic setting, but failure to identify non-Aspergillus molds limits its usefulness. Future work could focus on the usefulness of combinations of fungal biomarkers in pediatric cancer and HSCT.

Original languageEnglish
Pages (from-to)1340-1348
Number of pages9
JournalClinical Infectious Diseases
Volume63
Issue number10
DOIs
Publication statusPublished - Nov 15 2016

Keywords

  • ?-D-glucan
  • galactomannan
  • invasive fungal disease
  • pediatric
  • polymerase chain reaction

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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