[Toxoplasmosis and chronic myeloid leukemia]

Area of Science:

• Medical Parasitology
• Hematology
• Immunology

Background:

• Toxoplasmosis is a frequent and severe complication in patients with malignant hematological diseases, often leading to neurological issues.
• Diagnosing toxoplasmosis in these patients is challenging due to difficulties in parasite isolation and complex serological interpretations.
• Serological screening for toxoplasmosis is recommended for all malignant hemopathy patients.

Observation:

• A chronic myeloid leukemia patient, also a leucocyte donor, presented with persistent high IgG toxoplasma antibody levels but no IgM elevation.
• This serological profile, maintained for months, indicated an ongoing infection despite the absence of acute markers.
• The patient's condition highlights the diagnostic challenges and potential for asymptomatic parasite carriage.

Findings:

• High IgG titers for toxoplasmosis, even without IgM, can signify an active or increasing infection in immunocompromised individuals.
• Chronic myeloid leukemia patients may have a higher prevalence of elevated toxoplasma antibody titers.
• Leucocyte transfusions from infected donors can transmit toxoplasmosis, leading to post-transfusional infections.

Implications:

• Systematic screening for anti-toxoplasma antibodies in malignant hemopathy patients is essential for early diagnosis and intervention.
• Patients with high, stable IgG titers (even without IgM) should receive prompt toxoplasmosis treatment.
• Leucocyte donation screening for toxoplasmosis is critical to prevent transfusion-transmitted infections in vulnerable populations.