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Updated: Nov 8, 2025
Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
Published on: March 22, 2012
Evaluation of Aspergillus Lateral-Flow Test in Serum Samples of Pediatric Patients
Background:
Diagnosis of invasive aspergillosis (IA) in patients with hematologic malignancies and under the risk of IA may be uncertain or may delay because of nonspecific clinical presentation of the patients and difficult application techniques of conventional methods. Early diagnosis can provide initial antifungal therapy and prevent high mortality. In this study, we investigated the performance of an Aspergillus lateral-flow device (LFD) test (OLM Diagnostics, Newcastle upon Tyne, United Kingdom) for the diagnosis of IA in pediatric febrile neutropenic patients with hematologic malignancies.
Methods:
Three hundred and fourty seven serum samples of 26 febrile neutropenic episodes of 21 patients at risk for IA were tested. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the Aspergillus LFD test at episode level and at serum level were calculated.
Results:
According to the reference diagnostic criteria of IA, one proven and 13 probable IA episodes were defined. Twelve episodes (46.1%) did not meet the criteria for IA. The sensitivity, specificity, PPV, NPV, accuracy of the Aspergillus LFD test at episode level and at serum level were 14.3%, 100%, 100%, 50%, 53.8% and 12.1%, 100%, 100%, 50.8%, 53.9%, respectively.
Conclusions:
Aspergillus LFD test is an easy-to-use assay with short hands-on time; however, further study of the clinical utility in children and especially in serum samples are needed. It is a highly specific test for IA on bronchoalveolar lavage (BAL) samples but is not useful as a screening test for serum samples unless combined with galactomannan (GM) antigen test because of its potentially suboptimal sensitivity.
Insights
The Aspergillus lateral-flow device (LFD) test shows high specificity for diagnosing invasive aspergillosis (IA) in pediatric patients. However, its low sensitivity in serum samples necessitates further research for effective clinical utility.
Area of Science:
- Medical Diagnostics
- Mycology
- Hematology Oncology
Background:
- Diagnosing invasive aspergillosis (IA) in pediatric patients with hematologic malignancies is challenging due to nonspecific symptoms and difficult conventional methods.
- Early IA diagnosis is crucial for initiating antifungal therapy and reducing high mortality rates.
- This study evaluates the Aspergillus lateral-flow device (LFD) test for IA diagnosis in this high-risk pediatric population.
Purpose of the Study:
- To assess the diagnostic performance of the Aspergillus LFD test in pediatric febrile neutropenic patients with hematologic malignancies.
- To determine the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the LFD test at both episode and serum levels.
Main Methods:
- Analysis of 347 serum samples from 26 febrile neutropenic episodes in 21 at-risk pediatric patients.
- Calculation of diagnostic accuracy metrics for the Aspergillus LFD test at episode and serum levels.
Main Results:
- Of the 26 episodes, 14 met the criteria for proven or probable invasive aspergillosis (IA).
- The Aspergillus LFD test demonstrated high specificity (100%) but low sensitivity (14.3% at episode level, 12.1% at serum level).
- PPV was 100% for both levels, while NPV was 50% and 50.8%, respectively.
Conclusions:
- The Aspergillus LFD test is a user-friendly assay with minimal hands-on time.
- The test exhibits high specificity for IA in bronchoalveolar lavage (BAL) samples.
- Further studies are needed to establish the clinical utility of the LFD test in pediatric serum samples, especially when used as a standalone screening tool due to its suboptimal sensitivity.
