Immune competence in a patient with Hodgkin's disease and relapsing toxoplasmosis

Abstract

A 40 year old woman with Hodgkin's disease twice developed signs of encephalitis while being treated with prednisone and cyclophosphamide for 10 months. Since on both occasions her Toxoplasma dye test titer was 1 : 8000 or higher, she was treated on suspicion of toxoplasmosis with sulfadizine and pyrimethamine. Her tumor therapy was changed to bleomycin with lower doses of prednisone for 12 months. After death from central pontine myelinolysis, Toxoplasma and cytomegalovirus could be isolated, but no lesions attributable to these infectious agents were present. Maintenance of the patient's immune competence suggested an inquiry into the effects of the chemotherapeutic agents and of tumor infiltration for their respective interference with immunity. Using hamsters with chronic latent toxoplasmosis, it was found that both cortisone and cyclophosphamide caused recrudescence of chronic inapparent infection, that vinblastine and bleomycin interfered only slightly with the development of immunity, whereas in infiltrating lymphoma permitted immunity to develop normally. It is concluded that greater attention should be directed to the immunosuppressive effects of tumor treatment. By choice of an effective tumor therapy which is least immunosuppressive, and if necessary under cover of antimicrobial therapy, a patient with Hodgkin's disease can be aided in developing immunities which he may subsequently be able to maintain.

Genotypes of T. Gondii in Patients With Haematological Malignancies at a State Cancer Institute in South India

“…6 The frequency of acute toxoplasmosis during the present series was the same as reported by us earlier and so, the vast majority had reactivation of latent infection, which is the norm. 19 However, the overall frequency of toxoplasmosis in the present study was a little lower compared to our previous report-9.5% vs. 14%. 6 This drop in frequency could be explained due to cotrimoxazole prophylaxis, which is routinely instituted for the prevention of pneumocystis pneumonia during chemotherapy of paediatric ALL at our centre and majority of the patients in the present study were children.…”

Toxoplasma gondii Infection in Immunocompromised Patients: A Systematic Review and Meta-Analysis

“…The cancer can also reactivate latent T. gondii infection during antitumor treatment process (Frenkel et al, 1978). A variety of malignancies, including lymphoma, leukemia, and myeloma, can reactivate toxoplasmosis (Maciel et al, 2000; Kojima et al, 2010).…”

Neuroimmunopathology in Toxoplasmic Encephalitis

“…The neuroimmunopathogenesis should be fully explained at this point. There is evidence that toxoplasmosis can be reactivated in people with certain cancer types, including lymphoma, leukemia, and myeloma [10][11][12]. Organ transplantation also poses a significant risk of toxoplasmosis, which can be fatal.…”