Toxoplasmosis after allogeneic hematopoietic stem cell transplantation: Impact of serostatus-based management

Takahito Amikura, Taku Kikuchi, Jun Kato, Yuya Koda, Masatoshi Sakurai, Rie Yamazaki, Kei Mikita, Masuho Saburi, Tomonori Nakazato, Takehiko Mori

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
JournalTransplant Infectious Disease
DOIs
Publication statusAccepted/In press - 2020

Keywords

  • allogeneic hematopoietic stem cell transplantation
  • seroprevalence
  • serostatus
  • toxoplasmosis

ASJC Scopus subject areas

  • Infectious Diseases
  • Transplantation

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