@article{Cefalo_Puxeddu_Sarmati_paterno_Fontana_Nassa_Pane_De Bellis_Palmieri_Buzzatti_et al._2019, title={DIAGNOSTIC PERFORMANCE AND SAFETY OF BRONCHOALVEOLAR LAVAGE IN THROMBOCYTOPENIC HAEMATOLOGICAL PATIENTS FOR ASPERGILLOSIS DIAGNOSIS: A MONOCENTRIC, RETROSPECTIVE EXPERIENCE.}, volume={11}, url={https://www.mjhid.org/mjhid/article/view/2019.065}, DOI={10.4084/mjhid.2019.065}, abstractNote={<p><em>Background:</em> although bronchoalveolar lavage (BAL) measurements of galactomannan antigen (GM) seems to be more sensitive than serum testing to detect invasive pulmonary aspergillosis (IPA), a consensus on the most appropriate diagnostic threshold of the BAL GM test is still unclear. Moreover, there is uncertainty as to whether BAL is a safe procedure in patients with hematological malignancies (HM) and thrombocytopenia (TC).</p> <p><em>Objectives: b</em>ased on this background, 102 adult patients with HM and associated thrombocytopenia were retrospectively analyzed with the twin aims of 1) determining whether BAL is a safe and feasible procedure; and, 2) identifying the most appropriate threshold for GM positivity  in the diagnosis of IPA.</p> <p><em>Patients/Methods:</em> each BAL was considered as one case/patient. One hundred twelve BALs were carried out in 102 HM patients: at the time of the BAL, the median platelets count (PLTs) in all patients was 47x10<sup>9</sup>/L (1-476) and 31 patients (27%) had PLTs< 20x10<sup>9</sup>/L.</p> <p><em>Results:</em> complications from the BAL were infrequent (3.5%) and mild. No bleeding was reported. The BAL GM cut off of >0.8 was associated with the best diagnostic accuracy (sensitivity 72.97% and specificity 80%). Antifungal treatment of patients with BAL GM >0.8resulted in  a clinical-radiological improvement in 35/41patients (85%).</p> <p><em>Conclusions:</em> BAL was a safe procedure also in thrombocytopenic patients, permitting an IPA diagnosis not otherwise identifiable using  EORTC/MSG criteria. Our data suggest that a BAL GM value of>0.8 represents the most useful cut-off in terms of sensibility and specificity. Further prospective studies on a larger number of patients are needed to confirm these results.</p>}, number={1}, journal={Mediterranean Journal of Hematology and Infectious Diseases}, author={Cefalo, Mariagiovanna and Puxeddu, Ermanno and Sarmati, Loredana and paterno, giovangiacinto and Fontana, Carla and Nassa, Daniela and Pane, Gloria and De Bellis, Eleonora and Palmieri, Raffaele and Buzzatti, Elisa and et al.}, year={2019}, month={Oct.}, pages={e2019065} }