title: Infections of Blastocystis hominis and microsporidia in cancer patients: are they opportunistic?
abstract: Chemotherapy can cause immunosuppression, which may trigger latent intestinal parasitic infections in stools to emerge. This study investigated whether intestinal parasites can emerge as opportunistic infections in breast and colorectal cancer patients (n=46 and n=15, respectively) undergoing chemotherapy treatment. Breast cancer patients were receiving a 5-fluorouracil/epirubicin/cyclophosphamide (FEC) regimen (6 chemotherapy cycles), and colorectal cancer patients were receiving either an oxaliplatin/5-fluorouracil/folinic acid (FOLFOX) regimen (12 cycles) or a 5-fluorouracil/folinic acid (Mayo) regimen (6 cycles). Patients had Blastocystis hominis and microsporidia infections that were only present during the intermediate chemotherapy cycles. Thus, cancer patients undergoing chemotherapy should be screened repeatedly for intestinal parasites, namely B. hominis and microsporidia, as they may reduce the efficacy of chemotherapy treatments.
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Samudi
authors.initials: S
authors.lastname: Chandramathi
authors.forename: Kumar
authors.initials: K
authors.lastname: Suresh
authors.forename: Zarina Bustam
authors.initials: ZB
authors.lastname: Anita
authors.forename: Umah Rani
authors.initials: UR
authors.lastname: Kuppusamy
mesh_terms: D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000276:immunology*; D016845:Blastocystis hominis / Q000276:immunology / Q000472:pathogenicity*; D001943:Breast Neoplasms / Q000188:drug therapy*; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D003520:Cyclophosphamide / Q000009:adverse effects / Q000276:immunology; D015251:Epirubicin / Q000009:adverse effects / Q000276:immunology; D005243:Feces / Q000469:parasitology; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000276:immunology; D006801:Humans; D002955:Leucovorin / Q000009:adverse effects / Q000276:immunology; D008019:Life Style; D008296:Malaysia; D008297:Male; D016814:Microsporidia / Q000276:immunology / Q000472:pathogenicity*; D008875:Middle Aged; D009894:Opportunistic Infections / Q000209:etiology* / Q000276:immunology / Q000469:parasitology; D009944:Organoplatinum Compounds / Q000009:adverse effects / Q000276:immunology; D000077150:Oxaliplatin; D011795:Surveys and Questionnaires
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D015251:Epirubicin; D003520:Cyclophosphamide; D002955:Leucovorin; D005472:Fluorouracil