Investigation cryptococcus antigen presence with IMMY kit in pediatric oncology patients

Cryptococcus neoformans is an encapsulated fungus and its infections have gained importance as it is the causative agent of meningoencephalitis in patients with AIDS. However, information and data regarding Cryptococcus infections in oncology patients are limited. In recent years, an increase in the incidence of cryptococcosis has been reported in many types of malignancies, especially hematological malignancies such as leukemia and lymphoma. For this reason, in oncology patients in the risk group; Antigenemia research has gained importance for the prevention or early diagnosis of the disease. In the present study, the lateral flow antigen (LFA; lateral flow test) test, which is a point-of-care serological test that enables the early diagnosis of Cryptococcus disease in a rapid, low-cost and practical way and can detect Cryptococcus antigen (CrAg) in serum with high sensitivity and specificity, was used. For this test, the IMMY CrAg® Lateral Flow Assay, the only immunochromatographic measurement test approved by the American Food and Drug Administration (FDA), was preferred. Additionally, patients' demographic information, chemotherapy status, and ecological sources of the disease, such as pigeons, etc. Contact with bird species and contact with eucalyptus and similar trees were determined. In the study, 168 pediatric oncology patients who were under follow-up or newly diagnosed and who were admitted to the Pediatric Oncology outpatient clinic and 100 children without malignancy, selected as the malignancy-negative control group, were tested for CrAg. In the patient group, 112 were boys and 56 were girls. The average age was calculated as 8 years and 2 months (age range; 1 year, 2 months-18 years). Additionally, 133 (79%) of these patients had been receiving chemotherapy for at least 3 months. The other 35 (21%) patients were newly diagnosed and had not yet started chemotherapy. In addition, of the 100 malignancy-negative children in the control group, 59 were girls and 41 were boys. The presence of Cryptococcus antigen could not be detected in either group. As a result, although the prevalence of antigenemia in the pediatric oncology patient group and control group was determined to be 0%, our data should be supported by other studies and the prevalence of cryptococcosis representing the childhood period in our country should be determined. These studies will improve the care of children with asymptomatic Cryptococcus disease, raise the awareness of their families and healthcare personnel, and include CrAg screening in our country's Pediatric Oncology treatment guidelines.