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Post-Transplant Events

Chagas disease in bone marrow transplantation: an approach to preemptive therapy

Bone Marrow Transplantation volume 36, pages 123–129 (2005)Cite this article

Summary:

The efficacy of preemptive therapy was evaluated in bone marrow transplantation (BMT) recipients associated with Chagas disease (CD). The criterion to include patients in the protocol was the serological reactivity for CD in recipients and/or donors before transplant. After BMT, the monitoring was performed using the direct Strout method (SM), which detects clinical levels of Trypanosome cruzi parasitemia, and CD conventional serological tests. Monitoring took place during 60 days in ABMT and throughout the immunosuppressive period in allogeneic BMT. Reactivation of CD was diagnosed by detecting T. cruzi parasites in blood or tissues. In primary T. cruzi infection, an additional diagnostic criterion was the serological conversion. A total of 25 CD-BMT patients were included. Two ABMT and four allogeneic BMT recipients showed CD recurrences diagnosed by SM. One patient also showed skin lesions with T. cruzi amastigotes. Benznidazole treatment (Roche Lab), an antiparasitic drug, was prescribed at a dose of 5 mg/kg/day during 4–8 weeks with recovery of patients. Primary T. cruzi infection was not observed. This report proves the relevance of monitoring CD in BMT patients and demonstrates that preemptive therapy was able to abrogate the development of clinical and systemic disease.

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Acknowledgements

We are grateful to Dr Ernesto Efron, Chief of Infectology, and also doctors Rosana Jordán and Jorge Martínez of Hospital Británico from Buenos Aires, Argentina, for allowing us to include their patients in this study.

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Authors and Affiliations

  1. ICTEM Sanatorio Antártida, Buenos Aires, Argentina

    J Altclas & C Salgueira

  2. Instituto Nacional de Parasitología Dr M Fatala Chabén, ANLIS CG Malbrán, Buenos Aires, Argentina

    A Sinagra, C Luna, A M De Rissio, M M García & A Riarte

  3. Clínica Privada Independencia and Instituto Alexander Flemming, Buenos Aires, Argentina

    M Dictar & M T Verón

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  1. J Altclas
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  2. A Sinagra
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  3. M Dictar
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  4. C Luna
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  5. M T Verón
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  6. A M De Rissio
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  7. M M García
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  8. C Salgueira
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  9. A Riarte
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Correspondence to A Riarte.

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Altclas, J., Sinagra, A., Dictar, M. et al. Chagas disease in bone marrow transplantation: an approach to preemptive therapy. Bone Marrow Transplant 36, 123–129 (2005). https://doi.org/10.1038/sj.bmt.1705006

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  • DOI: https://doi.org/10.1038/sj.bmt.1705006

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