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Toxoplasmosis after allogeneic hematopoietic stem cell transplantation: Impact of serostatus‐based management
Author(s) -
Amikura Takahito,
Kikuchi Taku,
Kato Jun,
Koda Yuya,
Sakurai Masatoshi,
Yamazaki Rie,
Mikita Kei,
Saburi Masuho,
Nakazato Tomonori,
Mori Takehiko
Publication year - 2021
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.13506
Subject(s) - medicine , toxoplasmosis , serostatus , toxoplasma gondii , seroprevalence , incidence (geometry) , transplantation , population , hematopoietic stem cell transplantation , immunology , pediatrics , antibody , viral load , serology , human immunodeficiency virus (hiv) , physics , environmental health , optics
Toxoplasmosis caused by Toxoplasma gondii ( T. gondii ) is a serious infectious complication after allogeneic hematopoietic stem cell transplantation (HSCT). The incidence of toxoplasmosis varies widely because of the variabilities of seroprevalence among patient populations. The incidence and the optimal management of toxoplasmosis after allogeneic HSCT in a patient population with a low seroprevalence have not been fully evaluated. We conducted a single‐center retrospective study evaluating toxoplasmosis in Japanese patients who underwent allogeneic HSCT. Of the 728 evaluable patients, only 5 developed toxoplasmosis with a median onset of day 60 post‐transplant (range, day 55‐393). The cumulative incidence was 0.7% (95% CI: 0.3%‐1.5%) at day 500 post‐transplant. Four of the five patients succumbed due to toxoplasmosis. The more recently treated 220 patients (not the earlier 508 patients) were screened for the T. gondii serostatus, and prophylactic treatment with trimethoprim/sulfamethoxazole was applied. All five patients with toxoplasmosis were in the unscreened group, and there was no case of toxoplasmosis after the introduction of the screening and prophylactic treatment. Our results suggest that toxoplasmosis after allogeneic HST is rare but can develop as a life‐threatening complication even in the populations with low seroprevalence, and that prophylactic treatment for seropositive patients could effectively prevent toxoplasmosis.