Toxoplasmosis in children with neoplastic disease

ABSTRACT

Indirect fluorescent antibody test [I.F.A.T] IgG and IgM for Toxoplasmosis was performed in 94 children with neoplastic diseases 54 patients with Acute Lymphoblastic Leukemia [18 at diagnosis and 18 during treatment, 18 at relapse] and 40 patients with Hodgkin's disease [16 at diagnosis, 16 during treatment, 8 at relapse]. The neoplastic groups were compared to 17 healthy control children of similar age and sex. In the control group 3/17 [17.6 percent], in Hodgkin's disease 16/40 [H.D] [40 percent] and A.L.L. 16/54 [29.6 percent] were Toxoplasma IgG positive. Reactivation or acquisition of Toxoplasmosis was shown by generation of specific IgM antibodies. All the control cases proved to be Toxoplasma IgM negative. The prevalence of IgM Toxoplasmosis in Hodgkin's disease was 12/40 [30 percent] while the prevalence in the group at diagnosis 4/16 [25 percent] was also statistically significant by comparison to the control group. Hodgkin's disease predispose patients to infection by Toxoplasmosis. In the relapse group of A.L.L 6/18 [33.3 percent] were Toxoplasma IgM positive' which was statistically significant by comparison to the control group and was also associated with a higher antibody titre level up to 1/256. Relapse may pave the way for infection by Toxoplasmosis in A.L.L., 60 percent of Toxoplasma IgM positive A.L.L. patients received blood transfusion, a higher percentage 66 percent was shown in the relapsing group of A.L.L. So we suggest the selection of only Toxoplasma antibody - negative subjects to serve as blood donors for the support of patients with A.L.L and H.D. In immunosuppressed patients with neoplasms there is a significant frequency of Toxoplasma infection, and to increase recognition of this complication, routine serologic testing of such patients should be instituted