Clinical characteristics and incidence of toxoplasmosis after autologous hematopoietic stem cell transplantation: A retrospective study and literature review
Clinical characteristics and incidence of toxoplasmosis after autologous hematopoietic stem cell transplantation: A retrospective study and literature review
复制标题
自体造血干细胞移植后弓形虫病的临床特征及发病率的回顾性研究及文献复习
DOI：
10.1111/tid.13726
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发表时间：
2021
影响因子：
2.6
通讯作者：
Kobayashi Hikaru
中科院分区：
文献类型：
--
作者：
Kitahara Mari;Hiroshima Yuki;Norose Kazumi;Hikosaka Kenji;Kazumoto Hiroko;Uematsu Nozomu;Shishido Tsutomu;Kaiume Hiroko;Sato Keijiro;Ueki Toshimitsu;Sumi Masahiko;Watanabe Masahide;Kobayashi Hikaru
弓形虫病是一种罕见但危及生命的感染，发生在免疫功能低下的宿主中，包括异基因造血干细胞移植（allo‐HSCT）受者。然而，到目前为止，自体HSCT（auto-HSCT）受者中弓形虫病的临床特征和发病率仍然未知。本回顾性调查旨在分析1998年至2017年期间接受自体造血干细胞移植的152例患者。方法对109例（71.7%）受者进行弓形虫特异性IgG血清学检测，12例（11%）预HSCT受者弓形虫阳性。在12个收件人中，三个谁没有收到甲氧苄啶磺胺甲恶唑（TMP/SMX）预防开发脑，肺或播散性弓形虫病由于auto-HSCT后再激活和死亡，尽管treatment.ResultsThe弓形虫病的发病率分别为2%和25%之间的152 auto-HSCT收件人（5收件人接受auto-HSCT两次）和12个pre-HSCTT弓形虫阳性收件人，分别。此外，我们进行了文献综述，并确定了21例auto-HSCT后的弓形虫病病例。在这些以前的病例中，死亡率很高，特别是肺部和弥漫性弓形虫病。我们的研究结果表明，类似于异体HSCT后的弓形虫病，自体HSCT后的弓形虫病是一种致命的并发症。HSCT前检测弓形虫特异性IgG有助于检测弓形虫再活化，从而及时诊断和治疗。本研究首次揭示了日本血清学阳性患者中自体HSCT后弓形虫病的发病率。
BackgroundToxoplasmosis is a rare but life‐threatening infection occurring in immunocompromised hosts, including allogeneic hematopoietic stem cell transplantation (allo‐HSCT) recipients. However, thus far, the clinical features and incidence of toxoplasmosis in autologous HSCT (auto‐HSCT) recipients remain unknown. This retrospective survey aimed to analyze 152 patients who received auto‐HSCT between 1998 and 2017.MethodsSerological tests forToxoplasma gondii‐specific IgG were performed on 109 (71.7%) recipients, and 12 pre‐HSCT recipients (11%) wereToxoplasmaseropositive. Among the 12 recipients, three who did not receive trimethoprim‐sulfamethoxazole (TMP/SMX) prophylaxis developed cerebral, pulmonary or disseminated toxoplasmosis due to reactivation after auto‐HSCT and died despite treatment.ResultsThe incidences of toxoplasmosis were 2% and 25% among 152 auto‐HSCT recipients (five recipients received auto‐HSCT two times) and 12 pre‐HSCTToxoplasmaseropositive recipients, respectively. Further, we conducted a literature review and identified 21 cases of toxoplasmosis following auto‐HSCT. In these previous cases, the mortality rate was high, especially for pulmonary and disseminated toxoplasmosis. Our findings suggest that, similar to toxoplasmosis after allo‐HSCT, toxoplasmosis after auto‐HSCT is a fatal complication.ConclusionsSerial screening ofT. gondii‐specific IgG before HSCT could contribute to the detection ofToxoplasmareactivation and allow for prompt diagnosis and treatment. The present study is the first to reveal the incidence of toxoplasmosis after auto‐HSCT among seropositive patients in Japan.
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影响因子：
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作者：
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通讯作者：
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