title: Determining Toxoplasma high-risk autologous and allogeneic hematopoietic stem cell transplantation patients by systematic pre-transplant PCR screening of stem cell originated buffy coat.
abstract: The diagnosis of Toxoplasma infection or disease in hematopoietic stem cell transplantation (HSCT) patients is achieved mainly by PCR screening; however screening did not find wide field of use in practice due to costly expenditures of PCR. This study aimed to determine patients at high risk of Toxoplasma infection or disease before transplantation by stem cell originated buffy coat PCR and subsequently to screen them. Buffy coats collected from 12 autologous and 18 allogeneic HSCT patients' donors were investigated by PCR before transplantation. After transplantation, blood and sera collected at fixed time intervals were screened by two PCR methods and serological assays. Screening results first time assessed a toxoplasmosis incidence level as 25% in autologous HSCT patients and increased incidence level in allogeneic HSCT patients to 22%. Importantly, buffy coat PCR was first time performed before transplantation, to determine the risk of toxoplasmosis. Buffy coat PCR results showed that four patients were at high risk of toxoplasmosis before transplantation. After transplantation, these patients experienced toxoplasmosis. In conclusion, for the determination of patients at risk of toxoplasmosis, clinicians should consider buffy coat PCR in combination with serology before transplantation. After transplantation, PCR screening can be initiated in high risk patients upon clinical suspicion.
authors.affiliation: Department of Parasitology, Ege University Medical School, Bornova/Izmir, 35100, Turkey. ayse.caner@ege.edu.tr
authors.forename: Ayşe
authors.initials: A
authors.lastname: Caner
authors.forename: Ayhan
authors.initials: A
authors.lastname: Dönmez
authors.forename: Mert
authors.initials: M
authors.lastname: Döşkaya
authors.forename: Aysu
authors.initials: A
authors.lastname: Değirmenci
authors.forename: Murat
authors.initials: M
authors.lastname: Tombuloğlu
authors.forename: Seçkin
authors.initials: S
authors.lastname: Cağirgan
authors.forename: Edward
authors.initials: E
authors.lastname: Guy
authors.forename: Janet
authors.initials: J
authors.lastname: Francis
authors.forename: Nur Akad
authors.initials: NA
authors.lastname: Soyer
authors.forename: Yüksel
authors.initials: Y
authors.lastname: Gürüz
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D058621:Blood Buffy Coat / Q000469:parasitology*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods*; D012307:Risk Factors; D014122:Toxoplasma / Q000302:isolation & purification*; D014123:Toxoplasmosis / Q000469:parasitology / Q000517:prevention & control / Q000635:transmission*; D055815:Young Adult