the Application of an Electronic Nose in the Early detection of Aspergillosis II

Patients with prolonged chemotherapy-induced neutropenia are at risk for
invasive pulmonary aspergillosis (IPA). Incidence of IPA in this population is
somewhere around 8-14% and mortality is high. Diagnosing IPA is complex,
symptoms are non-specific and available diagnostic tools are either invasive or
have low sensitivity and specificity. This often results in a diagnostic delay,
with patients developing more extensive disease and in the meantime, increasing
the mortality. Therefore, improved (non-invasive) diagnostic tools are
desirable. In several diseases analysis of exhaled breath (using eNose) showed
to be a promising diagnostic tool. This is potentially a fast, easy-to-perform
and cheap addition to the diagnostic arsenal, improving diagnostic accuracy and
reducing the mortality of the infectious complications associated with the
treatment of hematological diseases.

1. To establish whether serial exhaled breath analysis using eNose can detect
invasive pulmonary aspergillosis in patients with prolonged chemotherapy
induced neutropenia (neutrophil counts <0.5 x 10^9 for more than 7 days).
2. To establish whether serial exhaled breath analysis in this group of
patients can detect invasive pulmonary aspergillosis at an earlier time point
than using the current state-of-the-art diagnostic strategy.
3. To find specific biomarkers in serum, exhaled breath condensate, serial
collected exhaled breath and broncho-alveolar lavage fluid by mass
spectrometry, aimed to accurately diagnose invasive pulmonary aspergillosis.
4. To construct an airway microbiome in patients with prolonged neutropenia at
different time points, comparing patients who develop invasive pulmonary
aspergillosis with neutropenic patients who do not, in order to get more
insights in the pathogenesis of invasive pulmonary aspergillosis.

Single center prospective cohort study

In this study there are no major risks and/or discomforts involved; discomfort
for the patient will be minimized by the involvement of only qualified
professionals in the procedures. The patients themselves will not directly
benefit from participating in this investigation. However, the population may
benefit from this study in the future if these novel diagnostic procedures
(f.e. exhaled breath analysis) prove to be applicable in clinical settings. As
such, we consider the balance between risks and discomfort for patients (low)
and benefit for the future population (potentially high) acceptable.