INTRODUCTION Invasive aspergillosis (IA) affects mainly patients with hematological malignancies, and early diagnosis is crucial for timely treatment. Most diagnoses are based on clinical and mycological criteria, mostly galactomannan (GM) test in serum or bronchoalveolar fluid, which is performed in case of clinical suspicion or as routine screening in patients at high risk who are not receiving anti-mold prophylaxis, for early detection of IA. The aim of this study was to assess in a real-world setting the efficacy of biweekly serum GM screening for the early detection of IA. METHODS A retrospective cohort that included 80 adult patients treated at the Hematology Department, Hadassah Medical Center, 2016-2020, with a diagnosis of IA. Clinical and laboratory data were collected from patients' medical files and the rate of GM-driven, GM-associated, and non-GM-associated IA was calculated. RESULTS There were 58 patients with IA. The rate of GM-driven diagnosis was 6.9%, GM-associated diagnosis was 43.1%, and non-GM-associated diagnosis was 56.9%. The GM test as a screening tool had led to IA diagnosis in only 0.2% of screened serums with a number needed to screen in order to find 1 patient with IA of 490. CONCLUSION Clinical suspicion outweighs GM screening as a tool for early diagnosis of IA. Nevertheless, GM has an important role as a diagnostic tool for IA.

中文翻译：

---

半乳甘露聚糖筛查用于早期检测高危血液肿瘤患者侵袭性曲霉病的实用性。

简介 侵袭性曲霉病（IA）主要影响血液系统恶性肿瘤患者，早期诊断对于及时治疗至关重要。大多数诊断基于临床和真菌学标准，主要是血清或支气管肺泡液中的半乳甘露聚糖 (GM) 检测，在临床怀疑的情况下进行，或作为未接受抗霉菌预防的高危患者的常规筛查，以早期发现IA 的检测。本研究的目的是在现实环境中评估每两周一次血清 GM 筛查对于早期发现 IA 的效果。方法 回顾性队列包括 2016 年至 2020 年在哈达萨医疗中心血液科接受治疗、诊断为 IA 的 80 名成年患者。从患者的医疗档案中收集临床和实验室数据，并计算 GM 驱动、GM 相关和非 GM 相关 IA 的发生率。结果 58 例 IA 患者。GM驱动的诊断率为6.9%，GM相关诊断为43.1%，非GM相关诊断为56.9%。GM 测试作为筛查工具，仅在 0.2% 的筛查血清中诊断出 IA，而要找到 1 名 IA 患者，则需要筛查 490 名患者。 结论 作为 IA 早期诊断工具，临床怀疑比 GM 筛查更重要。然而，GM 作为 IA 的诊断工具具有重要作用。