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Updated: Jan 6, 2026
Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
Published on: March 22, 2012
In-Hospital Mortality Among Hematological Malignancy Patients Undergoing Bronchoscopy for Suspected Invasive
N A Acet-Öztürk1, D Ömer-Topçu2, K V Acar3
1Faculty of Medicine, Department of Pulmonology, Uludağ University, Bursa, Turkey. niluferacet@gmail.com.
Introduction:
Invasive pulmonary aspergillosis (IPA) in hematological malignancy populations has high mortality rates. While there are identified prognostic factors for mortality, conflicting results are reported from the studies including bronchoalveolar lavage galactomannan (GM) measurements and co-infections. We aimed to evaluate risk factors associated with in-hospital mortality in a hematological malignancy population undergoing bronchoscopy with a preliminary diagnosis of IPA in a single tertiary care center.
Method:
Patients undergoing bronchoscopy with a preliminary diagnosis of IPA were included in this retrospective study. Bacterial co-infection was defined as a positive bacterial culture in respiratory samples within ± 7 days of the index bronchoscopy procedure.
Results:
Study population consisted 305 patients diagnosed as possible, probable or proven IPA. 57 patients presented with fungal and bacterial co-infection. In-hospital mortality was observed in 98 (33.6%) patients. Patients with mortality status were older and were not in remission for hematological malignancy. Serum GM, bronchoalveolar lavage (BAL) GM and bronchial lavage (BL) GM levels showed a significant relation with in-hospital mortality but weak accuracy. In multivariate analysis for risk factors of in-hospital mortality; age, remission status, number of nodules in HRCT and having fungal infections with or without combined bacterial infection were independent risk factors.
Conclusion:
Co-infections in this susceptible population should not be overlooked even in the presence of fungal infection evidence. BAL and BL GM tended to have a stronger relation with survival than serum GM measurements taken at the same time. The number of nodules in radiological assessment might be an indicator of mortality. Radiological changes through the disease course might be assessed in further studies.
Insights
Invasive pulmonary aspergillosis (IPA) in cancer patients is deadly. Age, remission status, nodules on CT scans, and co-infections independently predict mortality in these patients.
Area of Science:
- Pulmonology
- Oncology
- Infectious Diseases
Background:
- Invasive pulmonary aspergillosis (IPA) carries high mortality rates in hematological malignancy patients.
- Prognostic factors for IPA mortality, including galactomannan (GM) levels and co-infections, have conflicting evidence.
- This study evaluates risk factors for in-hospital mortality in hematological malignancy patients with suspected IPA.
Purpose of the Study:
- To identify independent risk factors for in-hospital mortality in hematological malignancy patients diagnosed with IPA.
- To analyze the association of fungal and bacterial co-infections with mortality.
- To compare the prognostic value of serum, bronchoalveolar lavage (BAL), and bronchial lavage (BL) GM measurements.
Main Methods:
- Retrospective study of 305 patients with possible, probable, or proven IPA undergoing bronchoscopy.
- Bacterial co-infection defined as positive respiratory bacterial culture within 7 days of bronchoscopy.
- Multivariate analysis to determine independent risk factors for in-hospital mortality.
Main Results:
- In-hospital mortality was 33.6% (98/305 patients).
- Independent risk factors for mortality included older age, non-remission status, number of HRCT nodules, and fungal infections with or without bacterial co-infection.
- Serum, BAL, and BL GM levels showed significant but weak associations with mortality; BAL/BL GM were stronger predictors than serum GM.
Conclusions:
- Bacterial co-infections are critical and should be considered in IPA patients.
- BAL and BL GM levels may be more indicative of survival than serum GM.
- The number of nodules on HRCT may serve as a mortality indicator.
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