Early Diagnosis of Aspergillosis in Patients at High Risk of Fungal Infection Caused by Treatment for Hematologic Cancer or Other Disease

The recruitment status of this study is unknown because the information has not been verified recently.
Verified September 2007 by National Cancer Institute (NCI).
Recruitment status was  Recruiting
Sponsor:
Information provided by:
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
NCT00462657
First received: April 18, 2007
Last updated: August 23, 2013
Last verified: September 2007

April 18, 2007
August 23, 2013
July 2005
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  • Sensitivity and specificity of galactomannan (GM) ELISA and real time PCR in detecting invasive aspergillosis (IA) [ Designated as safety issue: No ]
  • Diagnostic value of IA screening by GM ELISA and real time PCR, in terms of positive and negative predicative values [ Designated as safety issue: No ]
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Complete list of historical versions of study NCT00462657 on ClinicalTrials.gov Archive Site
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Early Diagnosis of Aspergillosis in Patients at High Risk of Fungal Infection Caused by Treatment for Hematologic Cancer or Other Disease
Early Diagnosis of Invasive Aspergillosis in a High Risk Group of Patients Using Serum and Bronchoalveolar Lavage Fluid Real Time PCR and Galactomannan ELISA

RATIONALE: Studying ways to diagnose fungal infections early may help doctors plan the best treatment.

PURPOSE: This clinical trial is studying laboratory tests to see how well they find aspergillosis early in patients at high risk of fungal infection caused by treatment for hematologic cancer or other disease.

OBJECTIVES:

Primary

  • Determine the test characteristics of galactomannan (GM) ELISA using serum and bronchoalveolar lavage fluid (BALF) collected from patients at high risk of invasive fungal infection.
  • Determine the test characteristics of aspergillus PCR using blood and BALF samples collected from these patients.
  • Evaluate the role of noninvasive exhaled breath condensate (EBC) in detecting invasive aspergillosis (IA).
  • Determine whether repeated measures over time or a combination of markers improves the test characteristics.
  • Establish cutoff points for the diagnosis of IA.

Secondary

  • Determine the inflammatory marker and cytokine profile of EBC in fungal infection and after bone marrow transplantation as a marker of acute lung injury.
  • Assess the role of bronchoscopy with bronchoalveolar lavage in identifying the causal pathogen early in the disease course of febrile neutropenic patients.
  • Assess the role of GM ELISA in prognosis and response to treatment for IA.
  • Assess the role of aspergillus PCR in prognosis and response to treatment for IA.

OUTLINE: This is a prospective study.

Patients are assessed for early diagnosis of invasive aspergillosis (IA) using serum and bronchoalveolar lavage fluid (BALF) evaluated by ELISA for galactomannan (GM) antigen and real time PCR for fungal DNA. Serum samples are collected at baseline and periodically during study, beginning with the onset of neutropenia and continuing until resolution of fever or recovery of neutrophil count. BALF samples are collected in patients with abnormal chest radiology evaluated by bronchoscopy and bronchoalveolar lavage. BALF is analyzed for GM antigen, fungal DNA, inflammatory markers, and cytokines.

Patients are also assessed using exhaled breath condensate (EBC) evaluated by GM ELISA and real time PCR. EBC is collected at baseline and periodically during study to detect GM antigen or fungal DNA and to measure markers of pulmonary inflammation and oxidative stress (e.g., pH, hydrogen peroxide, and leukotriene B4).

PROJECTED ACCRUAL: A total of 200 patients will be accrued for this study.

Interventional
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Primary Purpose: Diagnostic
  • Graft Versus Host Disease
  • Infection
  • Leukemia
  • Myelodysplastic Syndromes
  • Myelodysplastic/Myeloproliferative Neoplasms
  • Genetic: polymerase chain reaction
  • Other: bronchoalveolar lavage
  • Other: immunoenzyme technique
  • Other: laboratory biomarker analysis
  • Procedure: bronchoscopy
  • Procedure: management of therapy complications
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*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
200
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DISEASE CHARACTERISTICS:

  • At high risk for developing invasive aspergillosis (IA) due to any of the following risk factors:

    • Diagnosis of acute myeloid leukemia, myelodysplastic syndromes, or acute lymphoblastic leukemia AND meets ≥ 1 of the following criteria:

      • Receiving intensive chemotherapy with expected duration of neutropenia (ANC < 500/mm³) of > 10 days
      • Receiving high-dose steroids
    • Concurrent treatment with allogeneic hematopoietic stem cell transplantation (HSCT)
    • Requirement for high-dose steroids for graft-versus-host disease after HSCT
    • History of probable or proven IA and receiving chemotherapy
  • No preexisting chest disease

PATIENT CHARACTERISTICS:

  • Not specified

PRIOR CONCURRENT THERAPY:

  • See Disease Characteristics
Both
18 Years and older
No
United Kingdom
 
NCT00462657
CDR0000539539, BARTS-PECT2005, EU-20719, PFIZER-BARTS-PECT2005, SPRI-BARTS-PECT2005, GILEAD-BARTS-PECT2005, BARTS-05/Q0603/68
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St. Bartholomew's Hospital
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Study Chair: Samir G Agrawal, MD, PhD St. Bartholomew's Hospital
National Cancer Institute (NCI)
September 2007

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP