Usefulness of ß-D-glucan for diagnosis and follow-up of invasive candidiasis in onco-haematological patients

Abstract Objectives Definitive diagnosis of invasive candidiasis (IC) may be difficult to achieve in patients with haematological malignancy (PHM). We aimed to evaluate the performance of BDG for the diagnosis and the follow-up of IC in PHM. Methods We retrospectively reviewed the serological data of BDG assay in adult and paediatric PHM, who developed candidemia or chronic disseminated candidiasis (CDC) through a 4-year period. Sensitivity and kinetics of BDG were determined for both clinical forms. Results In a panel of 3027 PHM, incidence rates of candidemia and CDC ranged between 0.74 to 0.77 and, 0.30 to 0.44 according to the group of patients. At the time of diagnosis, 43.5% and 73% of cases of candidemia and CDC had a positive BDG assay, respectively. We found a significant correlation between the level of BDG at diagnosis and the outcome of candidemia (p=0.022). In all the cases of CDC, negative BDG results anticipated by 2 to 6 months the recovery of the CT-scan lesions. Conclusions BDG exhibits a low sensitivity to detect IC in PHM, but its kinetics correlates the clinical outcome. Additional studies are warranted in patients with CDC to evaluate the interest of monitoring BDG levels to anticipate the discontinuation of antifungal maintenance therapy.