Revista Clínica Española (English Edition) Revista Clínica Española (English Edition)
Rev Clin Esp 2002;202:148-51 - Vol. 202 Num.3
Toxoplasmosis después de tratamiento antineoplásico en linfoma no Hodgkin. Demanda de medidas preventivas
Toxoplasmosis after antineoplastic therapy in non-Hodgkin lymphoma. Demand of preventive measures.
S. García-Bujalancea, A. Ocampo Sáncheza, C. Ladrón de Guevara Garcíaa
a Servicio de Microbiolog??a y Parasitolog??a. Hospital La Paz. Madrid.
Abstract
Background. Toxoplasmosis is an opportunistic infection reported in several groups of inmunosupressed patients. It is considered uncommon in patients with lymphoproliferative disorders and in bone marrow transplant recipiets (BMT). Nevertheless, recent reviews have reported cases of cerebral and disseminated toxoplasmosis in BMT recipients, particularly among patients with IgG antibodies to Toxoplasma sp. prior to BMT and antineoplastic treatment. Patients and results. Two cases of toxoplasmosis are reported of patients with non-Hodgkin lymphoma who did not have graft-versus-host-disease and with positive antitoxoplasma serologic response. In the first patient, the predominant clinical picture was febrile neutropenia without source, with good response to specific treatment for toxoplasmosis; in the second patient, and autologous BMT was performed and six months later the patient developed a retino-choroiditis by toxoplasmosis reactivation. Conclusions. The excessive morbidity and mortality associated with toxoplasmosis reactivations in lymphomyeloproliferative neoplasms with antineoplastic therapy and both allogenic and autologous BMT, demand preventive measures. The pretransplant serologic tests can be helpful in evaluating the potential risk of suffering a reactivation by Toxoplasma sp. and considering the administration of chemoprophylaxis in selected patients with positive serology.
Palabras clave
toxoplasmosis, trasplante médula ósea, linfoma, profilaxis
Keywords
toxoplasmosis, bone marrow transplantation, lymphoma, prophylaxis
Rev Clin Esp 2002;202:148-51 - Vol. 202 Num.3