Computer tomography in pulmonary invasive aspergillosis in hematological patients with neutropenia: An useful tool for diagnosis and assessment of outcome in clinical trials

2010 ◽  
Vol 74 (3) ◽  
pp. e172-e175 ◽  
Author(s):  
Denis Caillot ◽  
Valérie Latrabe ◽  
Anne Thiébaut ◽  
Raoul Herbrecht ◽  
Stéphane De Botton ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Invasive Aspergillosis ◽  
Computer Tomography ◽  
Hematological Patients

scholarly journals Domestic mould exposure and invasive aspergillosis—air sampling ofAspergillusspp. spores in homes of hematological patients, a pilot study

2016 ◽  
Vol 54 (6) ◽  
pp. 576-583 ◽  
Author(s):  
KE Schweer ◽  
B Jakob ◽  
B Liss ◽  
H Christ ◽  
G Fischer ◽  
...  
Keyword(s):  
Pilot Study ◽  
Invasive Aspergillosis ◽  
Air Sampling ◽  
Hematological Patients

scholarly journals Comparison of Nonculture Blood-Based Tests for Diagnosing Invasive Aspergillosis in an Animal Model

2016 ◽  
Vol 54 (4) ◽  
pp. 960-966 ◽  
Author(s):  
P. Lewis White ◽  
Nathan P. Wiederhold ◽  
Juergen Loeffler ◽  
Laura K. Najvar ◽  
Willem Melchers ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Animal Model ◽  
Invasive Aspergillosis ◽  
Area Under The Curve ◽  
Diagnostic Strategy ◽  
Content Type ◽  
Multiple Tests ◽  
Antigen Tests ◽  
Guinea Pig Model

The EuropeanAspergillusPCR Initiative (EAPCRI) has provided recommendations for the PCR testing of whole blood (WB) and serum/plasma. It is important to test these recommended protocols on nonsimulated “in vivo” specimens before full clinical evaluation. The testing of an animal model of invasive aspergillosis (IA) overcomes the low incidence of disease and provides experimental design and control that is not possible in the clinical setting. Inadequate performance of the recommended protocols at this stage would require reassessment of methods before clinical trials are performed and utility assessed. The manuscript describes the performance of EAPCRI protocols in an animal model of invasive aspergillosis. Blood samples taken from a guinea pig model of IA were used for WB and serum PCR. Galactomannan and β-d-glucan detection were evaluated, with particular focus on the timing of positivity and on the interpretation of combination testing. The overall sensitivities for WB PCR, serum PCR, galactomannan, and β-d-glucan were 73%, 65%, 68%, and 46%, respectively. The corresponding specificities were 92%, 79%, 80%, and 100%, respectively. PCR provided the earliest indicator of IA, and increasing galactomannan and β-d-glucan values were indicators of disease progression. The combination of WB PCR with galactomannan and β-d-glucan proved optimal (area under the curve [AUC], 0.95), and IA was confidently diagnosed or excluded. The EAPRCI-recommended PCR protocols provide performance comparable to commercial antigen tests, and clinical trials are warranted. By combining multiple tests, IA can be excluded or confirmed, highlighting the need for a combined diagnostic strategy. However, this approach must be balanced against the practicality and cost of using multiple tests.

Galactomannan in bronchoalveolar lavage fluid for diagnosis of invasive aspergillosis in non-hematological patients

2016 ◽  
Vol 72 (6) ◽  
pp. 738-744 ◽  
Author(s):  
J. Fortún ◽  
P. Martín-Dávila ◽  
E. Gomez Garcia de la Pedrosa ◽  
J.T. Silva ◽  
J. Garcia-Rodríguez ◽  
...  
Keyword(s):  
Bronchoalveolar Lavage ◽  
Invasive Aspergillosis ◽  
Bronchoalveolar Lavage Fluid ◽  
Lavage Fluid ◽  
Hematological Patients

scholarly journals Impaired T Cell Responsiveness to Interleukin-6 in Hematological Patients with Invasive Aspergillosis

PLoS ONE ◽  
2015 ◽  
Vol 10 (4) ◽  
pp. e0123171 ◽  
Author(s):  
Jose F. Camargo ◽  
Alyajahan Bhimji ◽  
Deepali Kumar ◽  
Rupert Kaul ◽  
Rhea Pavan ◽  
...  
Keyword(s):  
T Cell ◽  
Invasive Aspergillosis ◽  
Interleukin 6 ◽  
Hematological Patients

P259 Immunological features of invasive aspergillosis in hematological patients after cytostatic chemotherapy

2013 ◽  
Vol 42 ◽  
pp. S124
Author(s):  
N. Klimko ◽  
O. Shadrivova ◽  
E. Frolova ◽  
L. Filippova ◽  
A. Uchevatkina ◽  
...  
Keyword(s):  
Invasive Aspergillosis ◽  
Hematological Patients ◽  
Cytostatic Chemotherapy

Caspofungin Acetate for Treatment of Invasive Fungal Infections

2003 ◽  
Vol 37 (1) ◽  
pp. 90-98 ◽  
Author(s):  
Staci A Pacetti ◽  
Steven P Gelone
Keyword(s):  
Clinical Trials ◽  
Invasive Aspergillosis ◽  
Clinical Data ◽  
Treatment Guidelines ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Current Therapy ◽  
Candida Spp ◽  
Fungal Cell

OBJECTIVE To briefly discuss the changing epidemiology of fungal infections and review currently available agents; provide a review of caspofungin; and discuss its pharmacology, pharmacokinetics, dosing guidelines, safety and efficacy, and role in the treatment of invasive fungal infections as it relates to current antifungal therapy. DATA SOURCES A MEDLINE (1966 to August 2002) database search using key words caspofungin, echino candins, fungal infections, and invasive aspergillosis, was completed to identify relevant articles including reviews, recent studies, treatment guidelines, and data from Merck and Company. STUDY SELECTION In vitro studies and all clinical trials were evaluated to summarize the clinical efficacy and safety of caspofungin. DATA SYNTHESIS The incidence of fungal infections is increasing as the population at risk expands. Cost, resistance, and morbidity and mortality are key issues. Adding to the antifungal armamentarium is necessary to address these therapeutic dilemmas. Caspofungin is the first member of a new class of antifungal agents, the echinocandins, to be approved for clinical use. Caspofungin is classified as a glucan synthase inhibitor and represents a class of agents with a novel mechanism of action. Unlike currently available agents (polyenes, pyrimidines, azoles) that exert their effect on the fungal cell membrane, the echinocandins are the first agents to inhibit fungal cell wall synthesis. Caspofungin exhibits activity against Aspergillus spp. and Candida spp., including non-albicans species. Data from clinical trials demonstrate that caspofungin is effective in patients with invasive aspergillosis as well as candida esophagitis. Its Food and Drug Administration–approved indication is limited to invasive aspergillosis refractory to or intolerant of current therapy. CONCLUSIONS Caspofungin has activity against Aspergillus spp. as well as a variety of Candida spp. Clinical data support its usefulness in the treatment of invasive aspergillosis and select candida infections. As additional clinical data become available, it seems likely that the therapeutic role of caspofungin will expand. THIS ARTICLE IS APPROVED FOR CONTINUING EDUCATION CREDIT ACPE UNIVERSAL PROGRAM NUMBER: 407-000-03-001-H01

scholarly journals Efficacy and safety of triazoles versus echinocandins in the treatment of invasive aspergillosis: A meta-analysis

2020 ◽  
Vol 77 (9) ◽  
pp. 974-985
Author(s):  
Sanja Uzelac ◽  
Radica Zivkovic-Zaric ◽  
Milan Radovanovic ◽  
Goran Rankovic ◽  
Slobodan Jankovic
Keyword(s):  
Clinical Trials ◽  
Invasive Aspergillosis ◽  
Therapeutic Option ◽  
Meta Analysis ◽  
Treatment Success ◽  
Poor Quality ◽  
Efficacy And Safety ◽  
Set Inclusion ◽  
Selection Of

Backgroun/Aim. Although majority of guidelines recommend triazoles (voriconazole, posaconazole, itraconazole and isavuconazole) as first-line therapeutic option for treatment of invasive aspergillosis, echinocandins (caspofungin, micafungin and anidulafungin) are also used for this purpose. However, head-to-head comparison of triazoles and echinocandins for invasive aspergillosis was rarely target of clinical trials. The aim of this meta-analysis was to compare efficacy and safety of triazoles and echinocandins when used for treatment of patients with invasive aspergillosis. Methods. This meta-analysis was based on systematic search of literature and selection of high-quality evidence according to pre-set inclusion and exclusion criteria. The literature search was made for comparison of treatment with any of triazoles (isavuconazole, itraconazole, posaconazole or voriconazole) versus any of echinocandins (caspofungin, anidulafungin or micafungin). The effects of triazoles (itraconazole, posaconazole or voriconazole) and echinocandins (caspofungin, anidulafungin or micafungin) were summarized using RevMan 5.3.5 software, and heterogeneity assessed by the Cochrane Q test and I? values. Several types of bias were assessed, and publication bias was shown by the funnel plot and Egger?s regression. Results. Two clinical trials and three cohort studies were included in this meta-analysis. Mortality in patients with invasive aspergillosis who were treated with triazoles was significantly lower than in patients treated with echinocandins [odds ratio 0.29 (0.13, 0.67)], and rate of favorable response (overall treatment success) 12 weeks after the therapy onset was higher in patients treated with triazoles [3.05 (1.52, 6.13)]. On the other hand, incidence of adverse events was higher with triazoles than with echinocandins in patients treated for invasive aspergillosis [3.75 (0.89, 15.76)], although this difference was not statistically significant. Conclusion.Triazoles (voriconazole in the first place) could be considered as more effective and somewhat less safe therapeutic option than echinocandins for invasive aspergillosis: However, due to poor quality of studies included in this meta-analysis, definite conclusion should await results of additional, well designed clinical trials.

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