Yeni Tanılı Çoklu Miyeloma Tanılı Hastalarda Blastocystis Hominis ve Gastrointestinal Sistem Parazitlerinin Yaygınlığı

Year 2024, Volume: 34 Issue: 5, 656 - 659, 31.10.2024

Cem Selim , İrfan Yavaş , Rafiye Ciftciler , Hatice Ertabaklar , Sema Ertuğ , Ali Bolaman

https://doi.org/10.54005/geneltip.1452726

Abstract

Giriş: Multipl miyelom (MM), kemik iliğinde anormal klonal plazma hücrelerinin varlığıyla karakterize hematolojik bir malignitedir. Multipl miyelom (MM) hastalarında görülen immün yetmezlik ciddi bir sorundur. Blastocystis sp. gastrointestinal sistemde bulunur ve insanları enfekte edebilir.
Arka Plan/ Amaçlar: Çalışmamızda, B. hominis ve diğer parazitlerin yaygınlığını kontrol grubu ve yakın zamanda multipl miyelom tanısı almış hastalarla karşılaştırdık.
Materyal-Yöntemler: Çalışmamıza merkezimizden 95 multipl miyelom hastası ve kontrol grubu olarak 95 gönüllü dahil edildi. Hastaların dışkı örnekleri alındığında herhangi bir semptomu yoktu. B. hominis için, üç ardışık dışkı örneği salin-lugol trikrom boyama ve formalin-etil asetat konsantrasyonu ile incelendi. Veriler kaydedildi ve SPSS 25.0 kullanılarak analiz edildi.
Sonuçlar: Yeni tanı almış multipl miyelomlu hastalar ve kontrol grubundaki hastaların hiçbirinde B.hominis dışında parazit yoktu. Yeni tanı almış MM hastaları ile kontrol grubu arasında dışkıda B.hominis görülme sayısı açısından anlamlı fark bulundu (p <0,001).
Tartışma: Bu sonuca göre MM hastalarında dışkıdaki parazit yükü artmıştır. Bu sonuç MM hastalarının bağışıklık sisteminin baskılanmasını yansıtıyor olabilir. Buna göre MM hastalarında tedavi sırasında ortaya çıkabilecek gastrointestinal semptomların varlığında B.hominis etken olarak düşünülmelidir.

Keywords

Multipl miyelom, Parazitler, Blastocystis hominis

The Prevalence of Blastocystis Hominis and Gastrointestinal System Parasites in Patients With Newly Diagnosed Multiple Myeloma Diagnosis

Abstract

Introduction: Multiple myeloma (MM) is a hematological malignancy characterized by the presence of abnormal clonal plasma cells in the bone marrow. Immunodeficiency seen in patients with multiple myeloma (MM) is a serious problem. Blastocystis sp. is found in the gastrointestinal tract and can infect humans.
Background/ Aims: In our study, we compared the prevalence of B.hominis and other parasites with the control group and patients who had recently been diagnosed with multiple myeloma.
Material-Methods: Ninety-five multiple myeloma patients from our center and 95 volunteers as a control group were included in our study. The patients did not have any symptoms when stool samples were taken. For B.hominis, three consecutive stool samples were examined by saline-lugol trichrome staining and formalin-ethyl acetate concentration. Data were recorded and analyzed using SPSS 25.0.
Results: Patients with newly diagnosed multiple myeloma and any of the patients in the control group did not have any parasites other than B.hominis. A significant difference was found between the newly diagnosed MM patients and the control group in terms of the number of B.hominis occurrences in the stool (p <0.001).
Conclusions: According to this result, parasite load in stool increased in patients with MM. This result may reflect the suppression of the immune system of patients with MM. Accordingly, B.hominis should be considered as a causative agent in the presence of gastrointestinal symptoms that may occur during treatment in patients with MM.

Keywords

Multiple myeloma, parasites, blastocystis hominis

References

• Robak P, Drozdz I, Szemraj J, Robak T. Drug resistance in multiple myeloma. Cancer Treat Rev 2018; 70: 199–208.
• Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin 2018; 68: 7–30.
• Palumbo A, Anderson K. Multiple myeloma. N Engl J Med. 2011; 364: 1046-1060.
• Blimark C, Holmberg E, Mellqvist U-H, Landgren, O, Björkholm M, Hultcrantz M, et al. Multiple myeloma and infections: a population-based study on 9253 multiple myeloma patients. Haematologica 2015; 100: 107–113.
• Suresh K, Smith H. Comparison of methods for detecting Blastocystis hominis. Eur J Clin Microbiol Infect Dis 2004; 23: 509-11.
• Taamasri P, Mungthin M, Rangsin R, Tongupprakarn B, Areekul W, Leelayoova S. Transmission of intestinal blastocystosis related to the quality of drinking water. Southeast Asian J Trop Med Public Health 2000; 31: 112–117.
• Tan KS. New insights on classification, identification, and Clinical relevance of Blastocystis spp. Clin Microbiol Rev 2008; 21 :639-65.
• Nagel R, Cuttell L, Stensvold CR, Mills PC, Bielefeldt‐Ohmann H, Traub RJ. Blastocystis subtypes in symptomatic and asymptomatic family members and pets and response to therapy. J Intern Med 2012; 42: 1187–1195.
• Yavasoglu I, Kadikoylu G, Uysal H, Ertug S, Bolaman AZ. Is Blastocystis hominis a new etiologic factor or a coincidence in iron deficiency anemia? Eur J Haematol 2008; 8 :47–50.
• Yersal O, Malatyali E, Ertabaklar S, Oktay E, Barutca S, Ertug S. Blastocystis subtypes in cancer patients: analysis of possible risk factors and clinical characteristics. Parasitol Int 2016; 65: 792–796.
• Ozyurt, O. Kurt, K. Molbak, Nielsen HV, Haznedaroglu T, Stensvold CR. Molecular epidemiology of Blastocystis infections in Turkey, Parasitol Int 2008; 57: 300–306.
• Pratt G, Goodyear O, Moss P. Immunodeficiency and immunotherapy in multiple myeloma. Br J Haematol 2007; 138: 563–579.
• Cook G, Campbell JD, Carr CE, Boyd KS, Franklin IM. Transforming growth factor beta from multiple myeloma cells inhibits proliferation and IL-2 responsiveness in T lymphocytes. J Leukoc Biol 1999; 66: 981–988.
• Ratta M, Fagnoni F, Curti A, Vescovini R, Sansoni P, Oliviero B, et al. Dendritic cells are functionally defective in multiple myeloma: the role of interleukin-6. Blood. 2002; 100: 230–237.
• Rawstron AC, Davies FE, Owen RG, Pratt G, Child JA, Morgan GJ, et al. B-lymphocyte suppression in multiple myeloma is a reversible phenomenon specific to normal B-cell progenitors and plasma cell precursors. Br J Haematol 1998; 100: 176–183.
• Tasova Y, Sahin B, Koltas S, Paydas S. Clinical significance and frequency of Blastocystis hominis in Turkish patients with hematological malignancy, Acta Med Okayama 2000; 54: 133-136.
• Laodim P, Intapan PM, Sawanyawisuth K, Laummaunwai P, Maleewong W. A hospital-based study of epidemiological and clinical data on Blastocystis hominis infection. Foodborne Pathog Dis 2012; 9: 1077–1082.
• Holbro A, Ahmad I, Cohen S, Jean Roy, Silvy L, Miguel C, et al. Safety and cost-effectiveness of outpatient autologous stem cell transplantation in patients with multiple myeloma. Biol Blood Marrow Transplant 2013; 19: 547–551.
• Poirier P, Wawrzyniak I, Albert A, Alaoui H El, Delbac F, Livrelli V. Development and evaluation of a real-time PCR assay for detection and quantification of Blastocystis parasites in human stool samples: prospective study of patients with hematological malignancies. Journal of clinical microbiology, 2011; 49(3), 975-983.