A case-series of Toxoplasmosis in hematopoietic stem cell transplantation: still a concern for endemic countries

Prestes, Daniel; Mendes, Clara; Batista, Marjorie Vieira; Ramos, Jéssica Fernandes; Schimidt, Jayr; Okay, Thelma Suely; Caiaffa, H.; Rocha, Vanderson; Costa, Sílvia Figueiredo

doi:10.1038/s41409-018-0179-4

Cited by 13 publications

(12 citation statements)

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“…In previous series, most toxoplasmosis cases occurred during the second or third months after allogeneic HCT, with a risk persisting across the first year of transplant and sometimes even later [10,11]. Cases occurring during the first 4 weeks of transplant have been rarely reported but seem to have a high mortality rate [1,5,7]. Our series clearly identifies toxoplasmosis as an early complication of allogeneic HCT.…”

Section: Discussionsupporting

confidence: 55%

“…Most cases of Toxoplasma are observed between 2 and 6 months after transplant, and even in the larger studies, early cases occurring before day 30 are very rare [1,5,7]. Because of recent, severe, and early cases of toxoplasmosis in our department, we reviewed all our Toxoplasma cases over the past 11 years, focusing on cases observed before day 30 after HCT.…”

Section: Introductionmentioning

confidence: 99%

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Toxoplasmosis as an Early Complication of Allogeneic Hematopoietic Cell Transplantation

Robin

Leclerc

Angebault

et al. 2019

Biology of Blood and Marrow Transplantation

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Among 419 consecutive allogeneic hematopoietic cell transplant recipients, we observed 17 (4.0%) cases of toxoplasmosis at a median time of day 45 (range, 6 to 322) after transplant. Seven of these 17 cases occurred before day 30 after transplant. Because of the lack of PCR screening and trimethoprim-sulfamethoxazole prophylaxis before engraftment, the diagnosis of toxoplasmosis was late, and 5 of these 7 patients died. Analyzing these cases, early Toxoplasma blood PCR screening, starting from transplant, is crucial.

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Section: Discussionsupporting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Toxoplasmosis as an Early Complication of Allogeneic Hematopoietic Cell Transplantation

Robin

Leclerc

Angebault

et al. 2019

Biology of Blood and Marrow Transplantation

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“…The risks associated with transplantation are inadequately documented and probably underestimated (23)(24)(25)(26). Toxoplasmosis can occur in recipients both of solid organs and of hematopoietic stem cell transplants and may be due to reactivation of a pre-existing latent infection, to a newly acquired food-borne infection, or to tissue cysts contained in a transplant (24). Recent data show a significantly lower 6-month survival rate for T. gondii-seropositive recipients, especially after allogeneic stem cell transplantation (38% vs. 84%; p <0.001) and liver transplantation (50% vs. 75%; p <0.001) (23).…”

Section: Immunosuppression Infection and Reactivation In Transplant Recipientsmentioning

confidence: 99%

Toxoplasmosis in Germany: Epidemiology, Diagnosis, Risk Factors, and Treatment

Pleyer¹,

Groß²,

Schlüter³

et al. 2019

Deutsches Ärzteblatt International

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Background: With approximately 30% of the world population infected, Toxoplasma gondii is one of the most widespread pathogenic parasites in both humans and animals and a major problem for health economics in many countries.Methods: This review is based on the findings of individual studies, meta-analyses, and Cochrane Reviews retrieved by a selective literature survey of the Medline and Google Scholar databases.Results: Current data indicate a high rate of Toxoplasma gondii infection in Germany, ranging from 20% to 77% depending on age (95% confidence interval for 18-to 29-year-olds [17.0; 23.1]; for 70-to 79-year-olds [72.7; 80.5]). Male sex, caring for a cat, and a body mass index of 30 or more are independent risk factors for seroconversion. Postnatally acquired (food-related) infection is predominant, but maternal-to-fetal transmission still plays an important role. While most infections are asymptomatic, congenital toxoplasmosis and reactivated Toxoplasma encephalitis in immunosuppressed persons (transplant recipients and others) are sources of considerable morbidity. Toxoplasma gondii infection of the retina is the most common cause of infectious uveitis in Germany. The diagnosis and treatment of this type of parasitic infection are particular to the specific organs involved in the individual patient. Conclusion:Desirable steps for the near future include development of an effective treatment for the cystic stage and identification of biomarkers to assess the risk of reactivation and predict the disease course.

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“…Toxoplasmosis after HSCT mainly manifests as disseminated toxoplasmosis, toxoplasmosis encephalopathy, toxoplasmosis ophthalmopathy and isolated fever 20 . According to our summary of patient data, central nervous system involvement is the most common presentation, accounting for 83.3% (15/18) of the cases.…”

Section: Discussionmentioning

confidence: 95%

Toxoplasma gondii infection in children after allogeneic hematopoietic stem cell transplantation: A case report and literature review

Luo

Shen

Chen

et al. 2021

Pediatric Investigation

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Introduction Toxoplasmosis is a life‐threatening complication after hematopoietic stem cell transplantation (HSCT). However, for several reasons, clinicians know little about Toxoplasma infection. Case presentation We report a case of toxoplasmosis that was diagnosed by bone marrow smear and metagenomic next‐generation sequencing (mNGS) after HSCT in a boy. Additionally, we summarize the characteristics of toxoplasmosis after pediatric HSCT reported in the literature published in PubMed. Conclusion Clinicians should increase their awareness of toxoplasmosis in children after HSCT and implement pre‐transplant screening and post‐transplant monitoring and prevention in future according to the national conditions of our country.

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A case-series of Toxoplasmosis in hematopoietic stem cell transplantation: still a concern for endemic countries

Cited by 13 publications

References 13 publications

Toxoplasmosis as an Early Complication of Allogeneic Hematopoietic Cell Transplantation

Toxoplasmosis as an Early Complication of Allogeneic Hematopoietic Cell Transplantation

Toxoplasmosis in Germany: Epidemiology, Diagnosis, Risk Factors, and Treatment

Toxoplasma gondii infection in children after allogeneic hematopoietic stem cell transplantation: A case report and literature review

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