Key clinical point: Twice-weekly surveillance with galactomannan enzyme immunoassay (GM-EIA) and b-D-glucan (BDG) assay was ineffective at detecting invasive fungal diseases (IFDs) in children, adolescents, and young adults with acute myeloid leukemia (AML) receiving antifungal prophylaxis.
Major finding: The negative predictive value was greater than 99% for an individual or combination of GM-EIA and BDG assays. However, true positive results were not observed in any sample collected within 7 days of an invasive aspergillosis/candidiasis diagnosis, resulting in sensitivity and positive predictive value for each test of 0%.
Study details: This observational study imbedded within a phase 3 Children’s Oncology Group trial ( ACCL0933) included 471 patients with AML (age, 3 months-30 years) receiving fluconazole (n=235) or caspofungin (n=236).
Disclosures: This study was supported by the National Cancer Institute’s (NCI) Biomarker, Imaging and Quality of Life Studies Funding Program, and the NCI support of the Children’s Oncology Group. Some investigators including the lead author reported ties with various pharmaceutical companies.
Source: Fisher BT et al. J Pediatric Infect Dis Soc. 2021 Jun 26. doi: 10.1093/jpids/piab036 .