Predictive Panel Detects Invasive Pulmonary Aspergillosis in Patients With Leukemia

Predictive Panel Detects Invasive Pulmonary Aspergillosis in Patients With Leukemia
Predictive Panel Detects Invasive Pulmonary Aspergillosis in Patients With Leukemia

A team of researchers discovered a method for early detection of aspergillosis, a potentially deadly fungal infection, in patients whose disease or treatment involves immune system suppression. The findings were published in PLoS One (doi:10.1371/journal.pone.0143165).

Patients undergoing chemotherapy for leukemia, bone marrow stem cell transplant, or lung transplant are some of those at risk for serious infection by the disease-causing Aspergillus fungus, a common mold in the environment that easily becomes airborne. When inhaled, the mold colonizes the respiratory tract. In patients with immune suppression from chemotherapy, the mold invades the bloodstream where it spreads and infects several organs including the liver, the lungs, and the brain. Healthy immune systems are able to destroy the inhaled mold before infection can occur.

Despite close monitoring for infection and aggressive anti-fungal therapy in vulnerable people, mortality is high (50% to 90%) depending on a patient's underlying disease and site of infection. Although early diagnosis can improve the patient's outcome, timely detection of the infection is difficult.

Currently, the infection is diagnosed via radiograph and tests that measure the levels of fungal molecules that produce an immune reaction in a patient's blood. However, test results are not very accurate and often lead to a wrong diagnosis.

For this study, the researchers reviewed patients undergoing chemotherapy for leukemia, bone marrow transplant, and lung transplant from several collaborating institutions. The team developed a multicomponent predictive panel for the presence of invasive pulmonary aspergillosis in patients with leukemia.

However, test results for the mold were different for each group of patients, so future diagnostic tests using this technology should be tailored for different medical conditions commonly linked with this infection.

Brasier, director of UTMB Institute for Translational Sciences, said the breakthrough was "an example of successful collaboration that brought together experts in several different scientific fields to approach a difficult problem." The team's discovery could translate to refined diagnostics, earlier treatment, and improved survival for patients affected by this infection. More studies will be needed to confirm and validate this panel as a diagnostic test in independent patients.

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