Non-invasive diagnosis of invasive aspergillosis in patients with haematological malignancies: a prospective diagnostic accuracy study
In brief
Adding pentraxin-3 raised aspergillosis detection to 84%, but reduced specificity
In a prospective study of high-risk patients with blood cancers, adding serum pentraxin-3 to urinary or serum fungal markers detected 31 of 37 invasive aspergillosis episodes, but correctly classified only 19 of 33 controls. The findings suggest the non-invasive panel could complement existing testing, but pentraxin-3 needs prospective validation because of its limited specificity.
- Journal
- Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases (Q1)
- Published
- 10 October 2026
- Study design
- Case-control study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Rutuja H Patil, Radim Dobiáš, Yuri Vanbiervliet, Robina Aerts, Katrien Lagrou, Johan Maertens, et al.
- PMID
- 42858895
- DOI
- 10.1016/j.cmi.2026.10.002
Why clinicians should know about it
- Picked for Microbiology (medical) (paper of the day, 12 October 2026): Non‑invasive diagnosis of invasive aspergillosis in haematology
Abstract
OBJECTIVES: To evaluate a non-invasive panel integrating urinary triacetylfusarinine C normalised to creatinine (uTafC/Cr), serum galactomannan (sGM) and serum pentraxin-3 (sPtx3) for detection of invasive aspergillosis (IA) in patients with haematological malignancies. METHODS: Prospectively collected urine and serum from 148 clinical episodes in 138 high-risk patients with haematological malignancies (Leuven, 2018-2021) were analysed in a diagnostic accuracy study (37 proven/probable IA episodes from 37 patients; 111 control episodes from 104 patients). Median sampling days relative to the diagnostic reference day (day 0) were +1 for urine uTafC/Cr, 0 for sGM and +2 for sPtx3. uTafC/Cr was quantified by liquid chromatography-mass spectrometry (LC-MS); sGM and sPtx3 by enzyme immunoassays. Prespecified cut-offs were used for sGM and uTafC/Cr; sPtx3 positivity was receiver operating characteristic-derived. Analytical TafC stability and the relative analytical sensitivity of LC-MS and MALDI-MS were assessed in validation experiments. RESULTS: sGM and uTafC/Cr showed no false positives in available control episodes (sGM, 0/98; uTafC/Cr, 0/111) and each detected 51.4% of IA episodes (19/37). sPtx3 alone showed sensitivity of 70.3% (26/37) and specificity of 58.3% (21/36). Adding sPtx3 to the uTafC/Cr or sGM pair increased case detection to 83.8% (31/37), with lower specificity in the complete-case control episode subset (57.6%; 19/33 control episodes). In a ±72 h paired-window analysis, bronchoalveolar lavage fluid (BALF) mycology, defined as BALF GM, Aspergillus PCR and/or fungal culture, was positive in 19/23 tested IA episodes (82.6%; 95% CI, 62.9-93.0%). TafC was stable at 4 °C, and LC-MS was more sensitive than MALDI-MS. CONCLUSIONS: uTafC/Cr or sGM provides an Aspergillus-focused non-invasive adjunct to BALF-based testing; sPtx3 increased case detection but had limited specificity and requires prospective validation.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.