| Objective: To evaluate the value of serum galactomannan (GM) in early diagnosis and follow-up of invasive aspergillosis (IA) in hematological patients with agranulocytosis.Methods: Samples were collected from patients in hematology department from March to September of 2008, who had a fever with the temperature over 38.5 and agranulocytosis (neutrophils < 0.5x109/L), and had no response to broad-spectrum antibiotics treatment. The detection of aspergillosis GM antigen in serum was carried out with ELISA method. The sensitivity and specificity of the method were evaluated in combination with lung CT imagine and/or sputum culture. The GM positive rate was estimated, and the value of GM was assessed in early diagnosis of IA and monitoring anti-aspergillosis treatment.Results: 127 blood samples were obtained from 94 patients with agranulocytosis. According to the FDA diagnosis criteria, GM value over 0.5 is considered positive. 46 cases among 94 patients were positive, with the rate of 48.94%. Combining with the change of lung CT imagine or the result of sputum culture, the sensitivity and specificity of detection were calculated as 80.85% and 82.98%, respectively. Except 5 cases who did not receive treatment, 41 patients were all given anti-aspergillus therapy. After at least one week of treatment, 28 patients were observed to have good response, and 2 cases of them who used fluconazole for treatment were considered as false positive. 13 patients showed no response and finally died of primary disease progression, with the mortality rate of 31.7%. GM values were monitored and found to be decreased to normal range in 13 patients who had response to the therapy, and increased in 3 patients who had poor outcomes.Conclusion: Serum GM detection can be used in early diagnosis of IA. No decrease or even increase of GM value after treatment indicates a poor curative effect, while normal GM value after treatment revels a better outcome.
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