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Existing guidelines provide useful algorithms for diagnostic procedures and treatment options, but they do not give recommendations on how to evaluate early success or failure and if or when it is best to change therapy. Here, we review the diagnostic techniques currently used in association with clinical findings and propose an approach using a combination of computer tomography, clinical and all available biomarkers and inflammation parameters, especially those positive at baseline, to assess early response in invasive pulmonary aspergillosis. Computed tomography scans should be carried out at regular intervals during early and long\u2010term follow\u2010up. Imaging on day seven, or even earlier in clinically unstable patients, combined with an additional testing of biomarkers and inflammatory markers in between, is needed for a reliable assessment at day 14. If no improvement is seen after 2\u00a0weeks of therapy or the clinical condition is deteriorating, a change of antifungal therapy should be considered. Alleged breakthrough infections or treatment failure should undergo early diagnostic workup, including tissue biopsies when possible, to retrieve fungal cultures for resistance testing.<\/jats:p>","DOI":"10.1111\/myc.12860","type":"journal-article","created":{"date-parts":[[2018,10,17]],"date-time":"2018-10-17T14:03:29Z","timestamp":1539785009000},"page":"486-493","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Diagnostic work up to assess early response indicators in invasive pulmonary aspergillosis in adult patients with haematologic malignancies"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7833-9202","authenticated-orcid":false,"given":"Werner J.","family":"Heinz","sequence":"first","affiliation":[{"name":"Klinikum Weiden Weiden W\u00fcrzburg university medical center  W\u00fcrzburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5446-7170","authenticated-orcid":false,"given":"J\u00f6rg J.","family":"Vehreschild","sequence":"additional","affiliation":[{"name":"Department for Internal Medicine German Centre for Infection Research University Hospital of Cologne Partner Site Bonn\u2010Cologne University of Cologne  K\u00f6ln Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4425-6134","authenticated-orcid":false,"given":"Dieter","family":"Buchheidt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\u2010Hematology and Oncology Mannheim University Hospital Heidelberg University  Mannheim Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,4,29]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12328"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1086\/651263"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1086\/592255"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12392"},{"key":"e_1_2_5_6_1","unstructured":"Fungal disease frequency.https:\/\/www.gaffi.org\/why\/fungal-disease-frequency\/. 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