{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T21:57:12Z","timestamp":1769205432351,"version":"3.49.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,6,22]],"date-time":"2012-06-22T00:00:00Z","timestamp":1340323200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Diagnosing invasive pulmonary aspergillosis (<jats:styled-content style=\"fixed-case\">IPA<\/jats:styled-content>) remains a challenge in patients with hematological malignancies. The clinical significance of testing bronchoalveolar lavage (<jats:styled-content style=\"fixed-case\">BAL<\/jats:styled-content>) samples both with polymerase chain reaction (<jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content>) and <jats:italic><jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>spergillus<\/jats:italic> galactomannan <jats:styled-content style=\"fixed-case\">ELISA<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">GM<\/jats:styled-content>) is unclear, and the <jats:styled-content style=\"fixed-case\">BAL<\/jats:styled-content> cutoff for <jats:styled-content style=\"fixed-case\">GM<\/jats:styled-content> has not been clearly evaluated yet.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using a validated nested <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content> assay and a <jats:styled-content style=\"fixed-case\">GM ELISA<\/jats:styled-content>, we prospectively examined <jats:styled-content style=\"fixed-case\">BAL<\/jats:styled-content> samples from 87 hematological patients at high risk of <jats:styled-content style=\"fixed-case\">IPA<\/jats:styled-content>. Of 76 (87%) evaluable patients, 29 patients had proven or probable disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The receiver operating characteristic (<jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content>) analysis of <jats:styled-content style=\"fixed-case\">GM<\/jats:styled-content> optical density (<jats:styled-content style=\"fixed-case\">OD<\/jats:styled-content>) cutoff levels yielded a <jats:styled-content style=\"fixed-case\">BAL OD<\/jats:styled-content> of 0.5 to be optimal. We identified 29 probable or proven cases based on this <jats:styled-content style=\"fixed-case\">OD<\/jats:styled-content>. Sensitivity and specificity for <jats:styled-content style=\"fixed-case\">BAL GM<\/jats:styled-content> were 0.79 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.62\u20130.9) and 0.96 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.86\u20130.99), respectively. For <jats:styled-content style=\"fixed-case\">BAL PCR<\/jats:styled-content>, sensitivity and specificity were 0.59 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.41\u20130.75) and 0.87 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.75\u20130.94), respectively. Combining <jats:styled-content style=\"fixed-case\">BAL GM<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content> for diagnosis showed a sensitivity and specificity rate of 0.55 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.38\u20130.72) and 1.0 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.93\u20131.0), respectively, if positivity was defined by positive results for both tests. If either positive <jats:styled-content style=\"fixed-case\">BAL GM<\/jats:styled-content> or positive <jats:styled-content style=\"fixed-case\">BAL PCR<\/jats:styled-content> results defined test positivity, the sensitivity was 0.83 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.65\u20130.92), and the specificity was 0.83 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.70\u20130.91)<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In terms of optimal sensitivity and specificity, a <jats:styled-content style=\"fixed-case\">GM OD<\/jats:styled-content> cutoff of 0.5 was determined for <jats:styled-content style=\"fixed-case\">BAL<\/jats:styled-content> samples. Positivity for both <jats:styled-content style=\"fixed-case\">GM<\/jats:styled-content> and <jats:italic><jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>spergillus <\/jats:italic><jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">BAL<\/jats:styled-content> makes a pulmonary aspergillosis highly likely.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1600-0609.2012.01806.x","type":"journal-article","created":{"date-parts":[[2012,6,1]],"date-time":"2012-06-01T09:28:26Z","timestamp":1338542906000},"page":"120-127","source":"Crossref","is-referenced-by-count":62,"title":["Diagnosing pulmonary aspergillosis in patients with hematological malignancies: a multicenter prospective evaluation of an <i><scp>A<\/scp>spergillus <\/i><scp>PCR<\/scp> assay and a galactomannan <scp>ELISA<\/scp> in bronchoalveolar lavage samples"],"prefix":"10.1111","volume":"89","author":[{"given":"Mark","family":"Reinwald","sequence":"first","affiliation":[{"name":"Mannheim University Hospital University of Heidelberg Mannheim Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgit","family":"Spiess","sequence":"additional","affiliation":[{"name":"Mannheim University Hospital University of Heidelberg Mannheim Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Werner J.","family":"Heinz","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine W\u00fcrzburg University Hospital W\u00fcrzburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rg J.","family":"Vehreschild","sequence":"additional","affiliation":[{"name":"1st Department of Internal Medicine Cologne University Hospital Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cornelia","family":"Lass\u2010Fl\u00f6rl","sequence":"additional","affiliation":[{"name":"Department of Hygiene and Microbiology Innsbruck University Hospital Innsbruck Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Kiehl","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Frankfurt\/Oder General Hospital Frankfurt\/Oder Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beate","family":"Schultheis","sequence":"additional","affiliation":[{"name":"University of Bochum\u2010Herne Marienhospital Herne Herne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan W.","family":"Krause","sequence":"additional","affiliation":[{"name":"5th Department of Internal Medicine Erlangen University Hospital Erlangen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans\u2010Heinrich","family":"Wolf","sequence":"additional","affiliation":[{"name":"5th Department of Internal Medicine Halle University Hospital Halle\/Saale Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hartmut","family":"Bertz","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine Freiburg University Hospital Freiburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georg","family":"Maschmeyer","sequence":"additional","affiliation":[{"name":"Klinikum Ernst\u2010von\u2010Bergmann Potsdam Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolf\u2010Karsten","family":"Hofmann","sequence":"additional","affiliation":[{"name":"Mannheim University Hospital University of Heidelberg Mannheim Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dieter","family":"Buchheidt","sequence":"additional","affiliation":[{"name":"Mannheim University Hospital University of Heidelberg Mannheim Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,6,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1086\/651262"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1086\/588660"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1086\/514349"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00506-08"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.37.10.3223-3228.1999"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0488"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1086\/647935"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.5.1811-1818.2003"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.37.12.3865-3871.1999"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1086\/321887"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2004.04904.x"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir185"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2009.05.001"},{"issue":"1","key":"e_1_2_6_15_1","first-page":"311","article-title":"[Recommendations for diagnostic bronchoalveolar lavage. German Society of Pneumology]","volume":"48","year":"1994","journal-title":"Pneumologie"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.05026-11"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0954-6111(06)80062-4"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2010.11.013"},{"key":"e_1_2_6_19_1","first-page":"89","article-title":"A systematic literature review on the diagnosis of invasive Aspergillosis using Polymerase Chain Reaction (PCR) from bronchoalveolar lavage clinical samples","volume":"24","author":"Tuon FF","year":"2007","journal-title":"Rev Iberoam Micol"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2010.01452.x"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1702045"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.42.12.5517-5522.2004"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1086\/383148"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.42.9.4154-4157.2004"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-0701"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2003.04308.x"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1439-0507.2005.01104.x"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1086\/429921"}],"container-title":["European Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1600-0609.2012.01806.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1600-0609.2012.01806.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T20:57:09Z","timestamp":1700600229000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1600-0609.2012.01806.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,6,22]]},"references-count":27,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2012,8]]}},"alternative-id":["10.1111\/j.1600-0609.2012.01806.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1600-0609.2012.01806.x","archive":["Portico"],"relation":{},"ISSN":["0902-4441","1600-0609"],"issn-type":[{"value":"0902-4441","type":"print"},{"value":"1600-0609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,6,22]]}}}