Association between Toxoplasma gondii exposure and hematological malignancies: A systematic review and meta-analysis. (November 2020)

• Record Type: Journal Article
• Authors: Kalantari, Narges; Gorgani-Firouzjaee, Tahmineh; Hassani, Saeed; Chehrazi, Mohammad; Ghaffari, Salman
• Is Part Of: Microbial pathogenesis. Volume 148(2020)
• Publication Date: 2020-11
• Subjects: Hematological malignancies -- Lymphoma -- Leukemia -- Systematic review and meta-analysis -- Toxoplasmosis -- T. gondii; Pathogenic microorganisms -- Periodicals; Pathology, Molecular -- Periodicals; Communicable Diseases -- microbiology -- Periodicals; Communicable Diseases -- parasitology -- Periodicals; Micro-organismes pathogènes -- Périodiques; Pathologie moléculaire -- Périodiques; Electronic journals; 616.9041
• DOI: 10.1016/j.micpath.2020.104440
• Languages: English
• ISSNs: 0882-4010

Abstract

Abstract: The possible association between Toxoplasma gondii infection and hematological malignancies has been suggested by several studies. The current systematic review and meta-analysis was directed to further understand this relationship. In the present study, five electronic databases were reviewed for T. gondii infection in patients with blood cancer. The random effects model and 95% confidence intervals (CI) were used to determine the overall odds ratio (OR). Heterogeneity was deliberate with Cochran's Q test and I 2 statistic. In total, 13 studies including 1504 patients with hematological neoplasia and 2622 subjects without any malignancies were included in this meta-analysis. Overall, 324 patients with blood cancer and 391 subjects without any malignancies were exposed to Toxoplasma infection. The pooled random effect favored a statistically significant increased risk of T. gondii infection in patients with hematological neoplasia compared with non-cancer individuals [OR = 2.43; 95% CI: 1.49–3.97; χ2 = 49.7, I 2 = 75.9%, P = 0.00]. Also, significant pooled ORs of positive association were observed for studies which measured anti- Toxoplasma antibodies (IgG) [OR = 2.66; 95% CI: 1.46–4.83; χ2 = 40.3; I 2 = 82.6%, P = 0.00]. T-value and P -value were obtained 0.20 and 0.85 by Harbords modified regression test. This meta-analysis demonstrates that toxoplasmosis may be associated with an elevated risk of hematological malignancies. Also, it has found that immunoglobulin class and types of blood cancer are the specific sources of heterogeneity. Additional studies should be performed to examine the impact of T. gondii infection in the onset or development of hematologic neoplasms in the future. Highlight: This systematic review and meta-analysis was evaluated the possible association between Toxoplasma gondii infection and haematological malignancies. The pooled random effect favored a statistically significant increased risk of T.gondii infection in patients with hematological neoplasia compared with non-cancer individuals [OR=2.43; 95% CI: 1.49-3.97; χ2=49.7, I2=75.9%, P=0.00]. Significant pooled ORs of positive association were observed for studies which measured anti- Toxoplasma antibodies (IgG) [OR=2.66; 95% CI: 1.46-4.83; χ2=40.3; I2=82.6%, P=0.00]. This meta-analysis demonstrates that haematological malignancies may be associated with elevated risks of toxoplasmosis. The current study has found that immunoglobulin class and types of blood cancer are the specific sources of heterogeneity.