KEY TAKEAWAYS
- The study aimed to investigate the added value of baseline chest CT in the early detection of IPA before initiation of classical induction chemo in AML patients.
- Researchers noticed that baseline chest CT scans are valuable for early IPA diagnosis and risk assessment in AML patients.
Invasive pulmonary aspergillosis (IPA) poses a significant threat to patients with acute myeloid leukaemia (AML), often leading to high mortality rates. Early detection of IPA is crucial for mitigating its burden in this vulnerable population.
Emilie Janssens and her team aimed to assess the utility of baseline chest CT scans performed before classical induction chemotherapy in AML patients to enhance early detection of IPA.
They performed an inclusive analysis, including adult patients undergoing first-line intensive chemotherapy for AML with an available baseline chest CT scan (±7 days). Data were retrieved from the electronic health record, and IPA was classified according to the EORTC/MSGERC 2020 consensus definitions.
About 99 patients were included between 2015 and 2019. During first-line treatment, 29/99 (30%) patients developed probable IPA. Among them, baseline chest CT was abnormal in 61/99 (62%), with 14/61 (23%) showing typical radiological signs for IPA. An abnormal scan indicated a trend towards a higher risk for IPA (HR: 2.12; 95% CI 0.95-4.84).
Ground glass opacities emerged as a strong predictor of IPA development (HR 3.35: 95% CI 1.61-7.00). No probable/proven IPA was diagnosed at baseline; however, bronchoalveolar lavage (BAL) was only performed in 7 patients at baseline. Approximately 12-week mortality was notably higher in patients with IPA (7 out of 26, 27% vs. 5 out of 59, 8%; P = .024).
The study concluded that baseline chest CT scans hold promise for early IPA diagnosis and risk estimation. In patients with abnormal baseline CT findings, consideration of bronchoalveolar lavage (BAL) should be more frequent, extending beyond those with typical radiological IPA signs. No funding was received to conduct this study.
Source: https://pubmed.ncbi.nlm.nih.gov/38477367/
Janssens E, Huygens S, Moors I, et al. (2024). “Baseline chest computed tomography for diagnosis of invasive aspergillosis in patients with acute myeloid leukaemia treated with intensive chemotherapy: A retrospective single-centre cohort study.” Mycoses. 2024 Mar;67(3):e13715. doi: 10.1111/myc.13715. PMID: 38477367.
