TY - JOUR
T1 - 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
T2 - A Systematic Review and Meta-Analysis
AU - Lehrnbecher, Thomas
AU - Robinson, Paula D.
AU - Fisher, Brian T.
AU - Castagnola, Elio
AU - Groll, Andreas H.
AU - Steinbach, William J.
AU - Zaoutis, Theoklis E.
AU - Negeri, Zelalem F.
AU - Beyene, Joseph
AU - Phillips, Bob
AU - Sung, Lillian
PY - 2016/11/15
Y1 - 2016/11/15
N2 - 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.
AB - 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.
KW - ?-D-glucan
KW - galactomannan
KW - invasive fungal disease
KW - pediatric
KW - polymerase chain reaction
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U2 - 10.1093/cid/ciw592
DO - 10.1093/cid/ciw592
M3 - Review article
AN - SCOPUS:84994414330
VL - 63
SP - 1340
EP - 1348
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 10
ER -